Provider Demographics
NPI:1033226477
Name:MP-CC PC
Entity Type:Organization
Organization Name:MP-CC PC
Other - Org Name:MIDWEST PULMONARY CRITICAL CARE PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-390-0606
Mailing Address - Street 1:8552 CASS STR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-390-0606
Mailing Address - Fax:402-390-0899
Practice Address - Street 1:8552 CASS STR
Practice Address - Street 2:SUITE 301
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-390-0606
Practice Address - Fax:402-390-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE098878Medicare ID - Type Unspecified
098878Medicare UPIN