Individual
BOB H MCINTIRE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7831 WAKELEY PLAZA, OMAHA, NE 68114
(402) 397-6344
(402) 397-6407
Mailing address
7831 WAKELEY PLAZA, OMAHA, NE 68114
(402) 397-6344
(402) 397-6407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12697
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0915611
MEDICAID
IA
Enumeration date
07/24/2006
Last updated
07/08/2007
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