Healthcare Provider Details

I. General information

NPI: 1841064086
Provider Name (Legal Business Name): NDUKAKU OGBONNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

983285 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3949
US

IV. Provider business mailing address

983285 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3285
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-5000
  • Fax: 402-559-8390
Mailing address:
  • Phone: 402-559-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number10264
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: