Daniel G Blomenberg

Individual provider Active NPI Pediatrics Physician · Norfolk, NE

NPI 1619985587 · NPPES record last updated Aug 16, 2007

Key facts

NPI
1619985587
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
17645 (NE)
Practice address
301 N 27TH St
Suite 1
Norfolk, NE 68701
Phone
(402) 844-8000
Fax
(402) 844-8047
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Fountain Point Laboratory LLC Current
since Aug 25, 2019
Accepting new patients

Locations

301 N 27th St
Ste 1
Norfolk, NE 68701
Phone (402) 844-8000

3901 W Norfolk Ave
Ste D
Norfolk, NE 68701
Phone (402) 844-8000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17645 NE Yes

Addresses

Primary practice location

301 N 27TH St
Suite 1
Norfolk, NE 68701

Mailing address

301 N 27TH St
Suite 1
Norfolk, NE 68701
Phone (402) 844-8000

Other providers in Norfolk, NE

All providers in Norfolk, NE · Pediatrics Physician in Nebraska

Sources for this page

Verify at the official NPI Registry.