MEDICARE: DR. GREGORY U. OCHUBA MD, PHD

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	207R00000X	Internal Medicine Physician	20130	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598870057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY U. OCHUBA MD, PHD

Provider Business Mailing Address
First Line	:	PO BOX 30019
Second Line	:	2915 GRANT STREET
City	:	OMAHA
State	:	NE
Zip	:	68103-1119
Country	:	US
Telephone Number	:	402-451-3553
Fax Number	:	402-453-2061

Provider Business Practice Location Address
First Line	:	2915 GRANT ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68111-3863
Country	:	US
Telephone Number	:	402-451-3553
Fax Number	:	402-453-2061

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	09/06/2012

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