Provider Demographics
NPI:1982888228
Name:DE GRADO, JUSTIN JAMES (MD, MS)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:JAMES
Last Name:DE GRADO
Suffix:
Gender:M
Credentials:MD, MS
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Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7710 MERCY RD STE 1000
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2323
Practice Address - Country:US
Practice Address - Phone:402-717-2500
Practice Address - Fax:402-717-2525
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAMD-54647208800000X
NE36801208800000X
CAC131145208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology