Healthcare Provider Details

I. General information

NPI: 1508197435
Provider Name (Legal Business Name): NEBRASKA HAND & SHOULDER INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 10/31/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 N ALPHA ST
GRAND ISLAND NE
68803-4318
US

IV. Provider business mailing address

716 N ALPHA ST
GRAND ISLAND NE
68803-4318
US

V. Phone/Fax

Practice location:
  • Phone: 308-389-3312
  • Fax: 308-389-3390
Mailing address:
  • Phone: 308-389-3312
  • Fax: 308-389-3390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DOLF R ICHTERTZ
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 308-389-3312