Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist |
NPI | 1043318603 |
---|---|
Provider Name | David D Greer |
First Address | Omaha, NE 68152-2139 |
Second Address | Omaha, NE 68152-2139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0901173 | (05) | IA |
09971 | BCBS (01) | NE |
47069681000 | (05) | NE |
87608 | COVENTRY HEALTH CARE (01) | NE |
F235055 | MIDLANDS CHOICE (01) | NE |