Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 18285 | NE |
NPI | 1003908864 |
---|---|
Provider Name | Wesley K Hubka |
First Address | Omaha, NE 68114-3629 |
Second Address | Omaha, NE 68114-3629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 28/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
050024919 | RR MEDICARE (01) | |
089304 | MEDICARE (01) |