Individual
DR. MOLLY OMIZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2200 NE NEFF RD, SUITE 302, BEND, OR 97701-4283
(541) 388-3978
(541) 278-8366
Mailing address
PO BOX 490, BEND, OR 97709-0490
(541) 388-3978
(541) 278-8366
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD17366
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD17366
STATE LICENSE
OR
Enumeration date
06/24/2008
Last updated
03/05/2014
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