Provider Demographics
NPI:1568423523
Name:TRAN, MICHEL C (MD)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:C
Last Name:TRAN
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 1:1726 N 131ST CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3623
Mailing Address - Country:US
Mailing Address - Phone:402-493-4845
Mailing Address - Fax:
Practice Address - Street 1:2501 CAPEHART ROAD
Practice Address - Street 2:EHRLING BERQUIST HOSPITAL - FAMILY HEALTH CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68113-2160
Practice Address - Country:US
Practice Address - Phone:402-294-6033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE14358171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE 32814Medicare UPIN