Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 5965 | NE |
Y | 213EG0000X | General Practice | 5965 | NE |
NPI | 1003885021 |
---|---|
Provider Name | Dr. Michael Stephen Kotopka |
First Address | Lincoln, NE 68516-6640 |
Second Address | Lincoln, NE 68516-6640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/07/2007 |