Provider Demographics
NPI:1942277272
Name:PRITZA, DAVID RANDALL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RANDALL
Last Name:PRITZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:D
Other - Middle Name:RANDALL
Other - Last Name:PRITZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7500 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2319
Mailing Address - Country:US
Mailing Address - Phone:402-398-5880
Mailing Address - Fax:402-398-6716
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:402-398-5880
Practice Address - Fax:402-398-6716
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17898207RC0000X
IAMD-30835207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE03874OtherBS NE
IA0961342Medicaid
IA34928OtherBS IA
NE03874OtherBS NE
NE264090Medicare ID - Type UnspecifiedMEDICARE NE
IA44640Medicare ID - Type UnspecifiedMEDICARE IA