Provider Demographics
NPI:1316971781
Name:CLOUGH, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:CLOUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:16909 LAKESIDE HILLS CT
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-4664
Mailing Address - Country:US
Mailing Address - Phone:402-717-0820
Mailing Address - Fax:402-717-0830
Practice Address - Street 1:16909 LAKESIDE HILLS CT
Practice Address - Street 2:SUITE 208
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-4664
Practice Address - Country:US
Practice Address - Phone:402-717-0820
Practice Address - Fax:402-717-0830
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE17646207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2929836Medicaid
NE02638OtherBCBS OF NEBRASKA
NEP00374040OtherRAILROAD MEDICARE
IA2929836Medicaid
NE02638OtherBCBS OF NEBRASKA