MEDICARE: HERMAN M GREENWALD M.D.

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	208800000X	Urology Physician	25343	IA
2	208800000X	Urology Physician	15990	NE

General Provider Information

NPI Number	:	1295733020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERMAN M GREENWALD M.D.

Provider Business Mailing Address
First Line	:	7261 MERCY RD
Second Line	:	NORTH BUILDING, FIRST FLOOR
City	:	OMAHA
State	:	NE
Zip	:	68124-2311
Country	:	US
Telephone Number	:	402-398-6254
Fax Number	:	402-829-8513

Provider Business Practice Location Address
First Line	:	7710 MERCY RD
Second Line	:	SUITE 406
City	:	OMAHA
State	:	NE
Zip	:	68124-2372
Country	:	US
Telephone Number	:	402-717-2500
Fax Number	:	402-717-2525

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	11/18/2019

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Directions to “ HERMAN M GREENWALD M.D.” Practice Location

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