Individual
STEPHEN ANDREW MCILMOIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1387
(541) 963-8421
(541) 963-1476
Mailing address
PO BOX 3290, LA GRANDE, OR 97850-7290
(541) 963-8421
(541) 963-1476
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
5101019465
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
DO166905
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500674427
—
OR
Enumeration date
07/07/2011
Last updated
08/14/2020
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