Healthcare Provider Details

I. General information

NPI: 1477514297
Provider Name (Legal Business Name): GREGORY ROBERT BEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14301 FNB PKWY STE 100
OMAHA NE
68154-7200
US

IV. Provider business mailing address

14301 FNB PKWY STE 100
OMAHA NE
68154-7200
US

V. Phone/Fax

Practice location:
  • Phone: 402-758-5233
  • Fax: 888-972-1672
Mailing address:
  • Phone: 402-758-5233
  • Fax: 888-972-1672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2010-00805
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number53606
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number27853
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD.205960
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9548A
License Number StateWY
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberP6142
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101246268
License Number StateVA
# 8
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number33279
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: