Healthcare Provider Details

I. General information

NPI: 1164471249
Provider Name (Legal Business Name): COLUMBUS GYNECOLOGY AND WOMEN'S HEALTH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 39TH AVE
COLUMBUS NE
68601-2256
US

IV. Provider business mailing address

2485 39TH AVE
COLUMBUS NE
68601-2256
US

V. Phone/Fax

Practice location:
  • Phone: 402-563-0123
  • Fax: 402-563-3229
Mailing address:
  • Phone: 402-563-0123
  • Fax: 402-563-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20571
License Number StateNE

VIII. Authorized Official

Name: DR. HARRY DIETER MUELLER
Title or Position: PRESIDENT
Credential: MD
Phone: 402-563-0123