MEDICARE: LARRY E SIREF M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	29568	IA
2	174400000X	Specialist	18671	NE
3	208800000X	Urology Physician	MD-29568	IA
4	208800000X	Urology Physician	18671	NE

General Provider Information

NPI Number	:	1043219546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY E SIREF M.D.

Provider Business Mailing Address
First Line	:	7261 MERCY RD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68124-2311
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 MERCY RD
Second Line	:	SUITE 406
City	:	OMAHA
State	:	NE
Zip	:	68124-2372
Country	:	US
Telephone Number	:	402-717-2500
Fax Number	:	402-717-2525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	04/09/2024

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Directions to “ LARRY E SIREF M.D.” Practice Location

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