Healthcare Provider Details

I. General information

NPI: 1467029496
Provider Name (Legal Business Name): MUHAMMAD GHALLAB MBBCH, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD STE 401
OMAHA NE
68124-2362
US

IV. Provider business mailing address

7710 MERCY RD STE 401
OMAHA NE
68124-2362
US

V. Phone/Fax

Practice location:
  • Phone: 402-280-4626
  • Fax: 402-280-4850
Mailing address:
  • Phone: 402-280-4626
  • Fax: 402-280-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number10034
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: