MEDICARE: MARY ELIZABETH HALLBERG NULL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207SG0201X	Clinical Genetics (M.D.) Physician	8265	NE

General Provider Information

NPI Number	:	1255824280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH HALLBERG NULL MD

Provider Business Mailing Address
First Line	:	982185 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-2185
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	982185 NEBRASKA MEDICAL CTR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-2185
Country	:	US
Telephone Number	:	402-559-4186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2018
Last Update Date	:	05/06/2026

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