Healthcare Provider Details

I. General information

NPI: 1780848531
Provider Name (Legal Business Name): CHRISTOPHER MARC BINGCANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EMILE 42ND ST
OMAHA NE
68198-1225
US

IV. Provider business mailing address

988102 NEBRASKA MEDICAL CTR
OMAHA NE
68198-8102
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-5208
  • Fax: 402-559-7782
Mailing address:
  • Phone: 402-559-5208
  • Fax: 402-559-7782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number27468
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: