Provider Demographics
NPI:1508197435
Name:NEBRASKA HAND & SHOULDER INSTITUTE, P.C.
Entity Type:Organization
Organization Name:NEBRASKA HAND & SHOULDER INSTITUTE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOLF
Authorized Official - Middle Name:R
Authorized Official - Last Name:ICHTERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-389-3312
Mailing Address - Street 1:716 N ALPHA ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4318
Mailing Address - Country:US
Mailing Address - Phone:308-389-3312
Mailing Address - Fax:308-389-3390
Practice Address - Street 1:716 N ALPHA ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4318
Practice Address - Country:US
Practice Address - Phone:308-389-3312
Practice Address - Fax:308-389-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty