Individual
TATE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
139 S. 140TH ST, OMAHA, NE 68131-3003
(402) 559-0390
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31644
NE
Other
Enumeration date
06/27/2016
Last updated
07/01/2019
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