Individual
ERIK THOR OTTERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Mailing address
8005 FARNAM DR STE 305, OMAHA, NE 68114-3426
(402) 390-4111
(402) 390-4115
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
21337
NE
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
21337
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03733
BCBS OF NEBRASKA
NE
05
—
0530154
—
IA
01
—
09-00253
SHARE ADVANTAGE/MERCY RD
NE
01
—
09-01143
SHARE ADVANTAGE/ LAKESIDE
NE
01
—
35110
MIDLANDS CHOICE
NE
05
—
47063010113
—
NE
Enumeration date
05/02/2006
Last updated
12/15/2023
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