Individual
LEO EUGENE OBERMILLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 W 8TH AVE STE 1000, SPOKANE, WA 99204-2327
(509) 474-4500
(509) 474-4487
Mailing address
101 W 8TH AVE, MOTHER GAMELIN BLDG, 3RD FLOOR, ROOM 207305, SPOKANE, WA 99204-2307
(509) 474-6842
(509) 474-6606
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
025209
WA
207RN0300X
Nephrology Physician
M5092
ID
207RN0300X
Nephrology Physician
MD00019462
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010000219
REGENCE BLUE SHIELD OF ID
—
05
—
805903500
—
ID
05
—
8111304
—
WA
Enumeration date
09/27/2006
Last updated
06/23/2021
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