Healthcare Provider Details

I. General information

NPI: 1467626937
Provider Name (Legal Business Name): NATHAN GRANT ASHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7205 W CENTER RD STE 104
OMAHA NE
68124-2387
US

IV. Provider business mailing address

555 N 30TH ST
OMAHA NE
68131-2136
US

V. Phone/Fax

Practice location:
  • Phone: 402-392-7684
  • Fax:
Mailing address:
  • Phone: 402-280-8100
  • Fax: 402-280-8103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number24597
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: