Individual
GREGORY SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4955 F STREET, OMAHA, NE 68117
(402) 717-2871
(402) 717-5231
Mailing address
PO BOX 4907, OMAHA, NE 68104
(800) 831-2402
(843) 569-4008
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
16321
NE
207ZC0500X
Cytopathology Physician
23140
IA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16321
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
23140
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06292
BCBS
NE
01
—
44193
BCBS
IA
Enumeration date
04/21/2006
Last updated
07/29/2010
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