Provider Demographics
NPI:1427070820
Name:AUERBACH, BENJAMIN HOWARD (DO)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:HOWARD
Last Name:AUERBACH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988102 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-8102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4242 FARNAM ST STE 550
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2813
Practice Address - Country:US
Practice Address - Phone:402-559-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2093208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL60031511OtherBCBS AL PROVIDER #
GA203668900OtherUS DOL
GA200137497OtherEVERGREEN PROVIDER NUMBER
GA307525OtherBLUE CROSS BLUE SHIELD GA
GA000951266BMedicaid
GABA0100901OtherDEA NUMBER
GA000951266DMedicaid
GAP00057143OtherRAILROAD MEDICARE ID #
GABA0100901OtherDEA NUMBER
GA511I250053Medicare PIN
GA203668900OtherUS DOL