Organization
55 MDOS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMA BHYRAVABHOTLA PA-C (DIRECTOR IPAP PHASE 2 PROGRAM)
(402) 232-8046
Entity
Organization
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(402) 232-8046
Mailing address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2014
Last updated
02/03/2015
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