Provider Demographics
NPI:1689754970
Name:VOSS, TOD (MD)
Entity Type:Individual
Prefix:
First Name:TOD
Middle Name:
Last Name:VOSS
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 1:112 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PIERCE
Mailing Address - State:NE
Mailing Address - Zip Code:68767-1344
Mailing Address - Country:US
Mailing Address - Phone:402-329-4320
Mailing Address - Fax:402-329-4033
Practice Address - Street 1:112 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PIERCE
Practice Address - State:NE
Practice Address - Zip Code:68767-1344
Practice Address - Country:US
Practice Address - Phone:402-329-4320
Practice Address - Fax:402-329-4033
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17214174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47070778100Medicaid
NEB90911Medicare UPIN
NE47070778100Medicaid