1750492393 NPI number — NORMAN E FERRER M.D.

Table of content: NORMAN E FERRER M.D. (NPI 1750492393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750492393 NPI number — NORMAN E FERRER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERRER
Provider First Name:
NORMAN
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750492393
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/28/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3755
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68103-0755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-354-2100
Provider Business Mailing Address Fax Number:
402-354-2155

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 RIDGE ST STE 312
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COUNCIL BLUFFS
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51503-4643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-396-7880
Provider Business Practice Location Address Fax Number:
712-396-7885
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  19210 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 29172 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 06293 . This is a "WELLMARK-1 EDMUNDSON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42150546517 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97493 . This is a "WELLMARK-LAKESIDE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3924225 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 42150546518 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5924225 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97492 . This is a "WELLMARK-CENTER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1924225 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 97494 . This is a "WELLMARK-S. 24TH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10026211300 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9095729 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 06299 . This is a "WELLMARK-ATLANTIC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20109 . This is a "BCBSN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 42150546520 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10026480117 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 23093 . This is a "WELLMARK-201 RIDGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2924225 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 42150546516 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6924225 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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