Provider Demographics
NPI:1487801494
Name:FALTYS, MEGAN MARIE (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:FALTYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 38TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-1616
Mailing Address - Country:US
Mailing Address - Phone:402-564-1338
Mailing Address - Fax:402-564-8902
Practice Address - Street 1:4214 38TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1616
Practice Address - Country:US
Practice Address - Phone:402-564-1338
Practice Address - Fax:402-564-8902
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47063490713Medicaid
NE2000OtherBCBS OF NE
NE096499Medicare PIN