Individual
CARSON DOUGLAS MINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
42ND AND EMILE ST 3225 S 44TH STREET OMAHA NE 68105, OMAHA, NE 68198-0001
(402) 559-6673
Mailing address
42ND AND EMILE ST 3225 S 44TH STREET OMAHA NE 68105, OMAHA, NE 68198-0001
(402) 559-6673
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
0000000000
IN
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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