Provider Demographics
NPI:1316182785
Name:GATEWAY DERMATOLOGY PC
Entity Type:Organization
Organization Name:GATEWAY DERMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-467-4361
Mailing Address - Street 1:600 N COTNER BLVD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-2343
Mailing Address - Country:US
Mailing Address - Phone:402-467-4361
Mailing Address - Fax:402-467-1864
Practice Address - Street 1:600 N COTNER BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-2343
Practice Address - Country:US
Practice Address - Phone:402-467-4361
Practice Address - Fax:402-467-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-12
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1288001OtherMEDICARE
NE10025726100Medicaid
NEB90846OtherUPIN