Provider Demographics
NPI:1528025608
Name:MICHELS, DALE E (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:E
Last Name:MICHELS
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 1:7441 O ST STE 400
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2466
Mailing Address - Country:US
Mailing Address - Phone:402-488-7400
Mailing Address - Fax:402-488-0739
Practice Address - Street 1:7441 O ST STE 400
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2466
Practice Address - Country:US
Practice Address - Phone:402-488-7400
Practice Address - Fax:402-488-0739
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12699207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE095268Medicare ID - Type UnspecifiedASHLAND
NE093486Medicare ID - Type UnspecifiedLINCOLN
NEB67628Medicare UPIN