| Martin M Mancuso Md Pc | |
|
11704 W Center Rd Ste 210 Omaha NE 68144-4327 | |
| (402) 334-3377 | |
| (402) 691-9922 |
| Full Name | Martin M Mancuso Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11704 W Center Rd Ste 210, Omaha, Nebraska |
| Authorized Official Name and Position | Mary Derouchey (PRACTICE MANAGER) |
| Authorized Official Contact | 4023300444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin M Mancuso Md Pc 11704 W Center Rd Ste 210 Omaha NE 68144-4327 Ph: (402) 334-3377 | Martin M Mancuso Md Pc 11704 W Center Rd Ste 210 Omaha NE 68144-4327 Ph: (402) 334-3377 |
| NPI Number | 1326233545 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 08/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326233545 | NPI | - | NPPES |
| 0903674 | Medicaid | IA | |
| 828013494 | Other | NE | TRAVELERS RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 14017 (Nebraska) | Primary |
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