Healthcare Provider Details

I. General information

NPI: 1972429215
Provider Name (Legal Business Name): RIDGE THOMAS MUHLBAUER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1619 LEAVENWORTH STREET
OMAHA NE
68102
US

IV. Provider business mailing address

3571 X AVE
MANILLA IA
51454-7560
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2050
  • Fax: 402-552-2172
Mailing address:
  • Phone: 712-269-0239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: