55 Mdos
NPI #1881095669 in Offutt Afb, Nebraska
Provider Information
- NPI Number
- 1881095669
- Entity Type
- Organization
- Organization Name
- 55 Mdos
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Sep 11, 2014
- Last Updated
- Feb 3, 2015
Practice Location
- Address
- 2501 CAPEHART RD
- City
- Offutt Afb
- State
- Nebraska
- ZIP Code
- 68113-1043
- Phone
- (402) 232-8046
Authorized Official
- Name
- RAMA BHYRAVABHOTLA, PA-C
- Title
- DIRECTOR IPAP PHASE 2 PROGRAM
- Phone
- (402) 232-8046
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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