Healthcare Provider Details

I. General information

NPI: 1891624227
Provider Name (Legal Business Name): MARCEL LEBAY MAFICE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15311 WHITMORE ST
BENNINGTON NE
68007-7495
US

IV. Provider business mailing address

15311 WHITMORE ST
BENNINGTON NE
68007-7495
US

V. Phone/Fax

Practice location:
  • Phone: 402-810-2318
  • Fax: 402-810-2318
Mailing address:
  • Phone: 402-810-2318
  • Fax: 402-810-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: