Ethan J Pugel, PAC
Physician Assistant in Omaha, NE. Individual provider (NPI-1).
NPI number1699476366
StatusActive
Last updated in NPPESMar 10, 2023
Details
- NPI
- 1699476366
- Entity type
- Individual (NPI-1)
- Name
- Ethan J Pugel
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 10, 2023
- Certification date
- Mar 10, 2023
- Last updated
- Mar 10, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 2906 | NE | Yes |
| 363A00000X | Physician Assistant | 119139 | IA |
Practice location
2725 S 144th St Ste 212Omaha, NE 68144-5253
Phone 402-637-0800 · Fax 402-637-0808
Mailing address
2725 S 144th St Ste 212Omaha, NE 68144-5253
Phone 402-637-0800 · Fax 402-637-0808
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 555 Physician Assistant providers in Omaha · All 40,392 providers in Omaha
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