Provider Demographics
NPI:1477514297
Name:BEYER, GREGORY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ROBERT
Last Name:BEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:14301 FNB PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-7200
Mailing Address - Country:US
Mailing Address - Phone:402-758-5233
Mailing Address - Fax:888-972-1672
Practice Address - Street 1:14301 FNB PKWY
Practice Address - Street 2:STE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-7200
Practice Address - Country:US
Practice Address - Phone:402-758-5233
Practice Address - Fax:888-972-1672
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-008052085R0202X
CO536062085R0202X
NE278532085R0202X
LAMD.2059602085R0202X
WY9548A2085R0202X
TXP61422085R0202X
VA01012462682085R0202X
SC332792085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025173601Medicaid
NCP00851475OtherRR MEDICARE
SCNC1132Medicaid
NC2076095Medicare PIN
OH2633074Medicaid
NC5914708Medicaid