Healthcare Provider Details

I. General information

NPI: 1205864154
Provider Name (Legal Business Name): MICHAEL J GERMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 N 14TH ST STE 201
LINCOLN NE
68521-2134
US

IV. Provider business mailing address

4501 S 70TH ST SUITE 110
LINCOLN NE
68516-4282
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-1455
  • Fax: 402-476-1670
Mailing address:
  • Phone: 402-489-3834
  • Fax: 402-489-5049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15996
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15996
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: