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General NPI Number Information
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NPI Number | 1063862712
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Entity Type | Individual
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Provider Name | CHRISTOPHER OMERZA M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 1000 LANGWORTHY ST
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City | DUBUQUE
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State | IA
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Zip | 52001-7365
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Country | US
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Telephone | 563-584-3450
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Fax | 563-584-3171
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Provider Business Mailing Address
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Address Line | 1000 LANGWORTHY ST
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City | DUBUQUE
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State | IA
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Zip | 52001-7365
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Country | US
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Telephone | 563-584-3450
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Fax | 563-584-3171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R-10624
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD-48193
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License Number State | IA
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