Ichtertz, Dolf R

Ichtertz, Dolf R is an sole proprietor health care provider with primary practice located at 716 N Alpha St , Grand Island NE 68803-4318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Ichtertz, Dolf R can be contacted via phone (308) 389-3312.

Contact Information

Primary practice address
716 N Alpha St Grand Island NE 68803-4318
Phone: (308) 389-3312
Fax: (308) 389-3390
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hand Surgery 207XS0106X 218344310 Nebraska

Profile Details

NPI number 1952492845
LBN Legal business name Ichtertz, Dolf R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952492845 NPPES
Nebraska Other 07250 BCBS PROVIDER ID
Nebraska MEDICAID 47082696900 BCBS PROVIDER ID
Nebraska Other 200036906 BCBS PROVIDER ID

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