Provider Demographics
NPI:1598870057
Name:OCHUBA, GREGORY U (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:U
Last Name:OCHUBA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30019
Mailing Address - Street 2:2915 GRANT STREET
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-1119
Mailing Address - Country:US
Mailing Address - Phone:402-451-3553
Mailing Address - Fax:402-453-2061
Practice Address - Street 1:2915 GRANT ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-3863
Practice Address - Country:US
Practice Address - Phone:402-451-3553
Practice Address - Fax:402-453-2061
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE20130207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47066671500Medicaid
NE47066671500Medicaid
G44711Medicare UPIN