Individual
NICHOLAS OMDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3803 SPRING ST, SUITE 600, RACINE, WI 53405-1660
(262) 687-8312
(262) 687-8796
Mailing address
3803 SPRING ST, SUITE 600, RACINE, WI 53405-1660
(262) 687-8312
(262) 687-8796
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
20631
WI
Other
Enumeration date
07/22/2006
Last updated
09/16/2010
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