Provider Demographics
NPI:1447355623
Name:ENSZ, GARY R (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:R
Last Name:ENSZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2115 14TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUBURN
Mailing Address - State:NE
Mailing Address - Zip Code:68305-1797
Mailing Address - Country:US
Mailing Address - Phone:402-274-4993
Mailing Address - Fax:402-274-4905
Practice Address - Street 1:2115 14TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:NE
Practice Address - Zip Code:68305-1797
Practice Address - Country:US
Practice Address - Phone:402-274-4993
Practice Address - Fax:402-274-4905
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2010-06-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE14016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47075088600Medicaid
NE47075088600Medicaid
NE090843Medicare ID - Type Unspecified