Provider Demographics
NPI:1831269612
Name:PRESCHER, SCOTT W (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:W
Last Name:PRESCHER
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 1:1301 NO 72 ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-1903
Mailing Address - Country:US
Mailing Address - Phone:402-504-4663
Mailing Address - Fax:402-504-4668
Practice Address - Street 1:1301 NO 72 ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-1903
Practice Address - Country:US
Practice Address - Phone:402-504-4663
Practice Address - Fax:402-504-4668
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0100274OtherUHC
NE39204012700Medicaid
NE35694OtherBCBS
NE39204012700Medicaid
NE35694OtherBCBS