Provider Demographics
NPI:1164490140
Name:PRITZA, RONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:PRITZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2319
Mailing Address - Country:US
Mailing Address - Phone:402-398-5880
Mailing Address - Fax:402-398-6716
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:402-398-5880
Practice Address - Fax:402-398-6716
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD34745207RC0000X
NE20779207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE35845OtherBS NE
IA0560839Medicaid
IA34929OtherBS IA
NE35845OtherBS NE
IAI6860Medicare ID - Type UnspecifiedMEDICARE IA
NE275187Medicare ID - Type UnspecifiedMEDICARE NE