Individual
BERNARD WALTER DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16128 DAVENPORT ST, OMAHA, NE 68118-4046
(402) 578-2645
Mailing address
16128 DAVENPORT ST, OMAHA, NE 68118-4046
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17338
NE
Other
Enumeration date
08/20/2006
Last updated
01/14/2016
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