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NPI Code Detail

MEDICARE: SUSAN C OHNOUTKA MD

MEDICARE: SUSAN C OHNOUTKA MD
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
1207R00000XInternal Medicine Physician22668NE

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1096555014OTHERNEMEDICARE

General Provider Information

NPI Number : 1760490981
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN C OHNOUTKA MD
Provider Business Mailing Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3531
Fax Number : 402-413-3535
Provider Business Practice Location Address
First Line : 5401 SOUTH ST
Second Line :
City : LINCOLN
State : NE
Zip : 68506-2150
Country : US
Telephone Number : 402-413-3531
Fax Number : 402-413-3535
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2006
Last Update Date : 03/12/2015

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Directions to “ SUSAN C OHNOUTKA MD” Practice Location

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