Provider Demographics
NPI:1649368804
Name:DRESBACH, ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:DRESBACH
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 1:6825 S 27TH ST
Mailing Address - Street 2:STE 201
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-4872
Mailing Address - Country:US
Mailing Address - Phone:402-477-4545
Mailing Address - Fax:402-477-4842
Practice Address - Street 1:3901 PINE LAKE RD STE 335
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5497
Practice Address - Country:US
Practice Address - Phone:402-483-3700
Practice Address - Fax:402-483-3732
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEH27931Medicare UPIN
NE278117Medicare ID - Type Unspecified