NPI 1508978693 · live from the CMS NPI Registry
Brock Randall Angelos, DPM
Podiatrist in Lincoln, NE. National Provider Identifier 1508978693, active.
NPI record
| NPI | 1508978693 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 4213 O St, Lincoln, NE 68510 |
| Practice phone | 402-488-8114 |
| Enumerated | August 31, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 194 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.