Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 17646 | NE |
NPI | 1316971781 |
---|---|
Provider Name | David Clough |
First Address | Omaha, NE 68130-4664 |
Second Address | Omaha, NE 68130-4664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 12/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02638 | BCBS OF NEBRASKA (01) | NE |
2929836 | (05) | IA |
C14560 | (02) | NE |
P00374040 | RAILROAD MEDICARE (01) | NE |