Individual
JUSTIN MORAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10060 REGENCY CIR, OMAHA, NE 68114
(402) 354-1405
(402) 354-1599
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1609
NE
207QA0505X
Adult Medicine Physician
1609
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026480100
—
NE
05
—
1043604614
—
IA
05
—
47068731734
—
NE
05
—
47068731741
—
NE
05
—
47068731742
—
NE
05
—
47068731749
—
NE
Enumeration date
03/23/2015
Last updated
07/20/2018
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