Provider Demographics
NPI:1083198519
Name:MARK E OBERLIES MD PC
Entity Type:Organization
Organization Name:MARK E OBERLIES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:OBERLIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-616-4360
Mailing Address - Street 1:16909 LAKESIDE HILLS CT STE 111
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4661
Mailing Address - Country:US
Mailing Address - Phone:402-435-1400
Mailing Address - Fax:402-858-1281
Practice Address - Street 1:16909 LAKESIDE HILLS CT STE 111
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4661
Practice Address - Country:US
Practice Address - Phone:402-435-1400
Practice Address - Fax:402-858-1281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty