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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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