Healthcare Provider Details

I. General information

NPI: 1194427005
Provider Name (Legal Business Name): MITCHELL TIMOTHY SALKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

986270 NEBRASKA MEDICAL CTR
OMAHA NE
68198-6270
US

IV. Provider business mailing address

986270 NEBRASKA MEDICAL CTR
OMAHA NE
68198-6270
US

V. Phone/Fax

Practice location:
  • Phone: 402-391-3800
  • Fax: 402-934-1676
Mailing address:
  • Phone: 402-391-3800
  • Fax: 402-934-1676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number10498
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: