Provider Demographics
NPI:1164471249
Name:COLUMBUS GYNECOLOGY AND WOMEN'S HEALTH, PC
Entity type:Organization
Organization Name:COLUMBUS GYNECOLOGY AND WOMEN'S HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:DIETER
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-563-0123
Mailing Address - Street 1:2485 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2256
Mailing Address - Country:US
Mailing Address - Phone:402-563-0123
Mailing Address - Fax:402-563-3229
Practice Address - Street 1:2485 39TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2256
Practice Address - Country:US
Practice Address - Phone:402-563-0123
Practice Address - Fax:402-563-3229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025371900Medicaid
099832Medicare PIN