Individual
MR. PRESTON S OMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1510 12TH AVE RD STE 200, NAMPA, ID 83686-6008
(208) 302-6800
(208) 302-6855
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24019
NE
208000000X
Pediatrics Physician
M-11679
ID
Other
Enumeration date
05/14/2007
Last updated
04/26/2024
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