Provider Demographics
NPI:1194883298
Name:OBERLIES, MARK E (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:OBERLIES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16909 LAKESIDE HILLS CT STE 111
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4661
Mailing Address - Country:US
Mailing Address - Phone:402-810-9700
Mailing Address - Fax:402-858-1281
Practice Address - Street 1:16909 LAKESIDE HILLS CT STE 111
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130
Practice Address - Country:US
Practice Address - Phone:402-810-9700
Practice Address - Fax:402-858-1281
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
NE21729207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB07253610OtherDEA
H45832Medicare UPIN