Individual
IMAD OMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6029 WALNUT GROVE RD # C002, MEMPHIS, TN 38120-2112
(901) 685-3490
(901) 685-3499
Mailing address
6799 GREAT OAKS RD STE 250, MEMPHIS, TN 38138-2584
(901) 685-3490
(901) 685-3499
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD36446
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04026851
—
MS
05
—
09016197
—
MS
05
—
3721649
—
TN
05
—
3876262
—
TN
01
—
4043619
BCBST
TN
Enumeration date
03/02/2006
Last updated
01/03/2019
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