Provider Demographics
NPI:1417572918
Name:MANRIQUEZ MARTINEZ, GERSON GIBRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GERSON
Middle Name:GIBRAN
Last Name:MANRIQUEZ MARTINEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:983255 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-3255
Mailing Address - Country:US
Mailing Address - Phone:402-559-6160
Mailing Address - Fax:402-559-9080
Practice Address - Street 1:983255 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-3255
Practice Address - Country:US
Practice Address - Phone:402-559-6160
Practice Address - Fax:402-559-9080
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE8764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology