Individual
DR. MARK WILLIAM SERBOUSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 EAST H STREET, MCCOOK, NE 69001-1207
(308) 344-4110
(304) 344-8369
Mailing address
1401 EAST H STREET, PO BOX 1207, MCCOOK, NE 69001-1207
(308) 345-4110
(308) 345-8369
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17178
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080051714
RAILROAD MEDICARE
NE
01
—
4297
BLUE CROSS BLUE SHIELD
NE
05
—
47074801112
—
NE
Enumeration date
10/03/2005
Last updated
11/17/2009
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