Gresham Internal Medicine Clinic in Portland - Internal Medicine
Gresham Internal Medicine Clinic - NPI 1134204340
Gresham Internal Medicine Clinic is a Internal Medicine in Portland, Oregon. Gresham Internal Medicine Clinic practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Gresham Internal Medicine Clinic is 1134204340. The last update date is 2008-12-11.
Gresham Internal Medicine Clinic's current location address is Po Box 23200, Portland, Oregon. You can contact this provider via phone number 5036671015 and fax number 5036670406. The mailing address for Gresham Internal Medicine Clinic is Po Box 23200, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Gresham Internal Medicine Clinic |
|---|---|
| Address | Po Box 23200, Portland, Oregon |
| Phone Number | 5036671015 |
| Fax Number | 5036670406 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/PART |
|---|---|
| Authorized Official Name | Custis M John |
| Credentials | MD |
| Telephone Number | 5036671015 |
NPI Number Detail
| NPI Number | 1134204340 |
|---|---|
| Provider Enumeration Date | 2006-10-26 |
| Last Updated Date | 2008-12-11 |
Provider Mailing Address Detail
| Address | Po Box 23200 |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972813200 |
| Phone Number | 5036671015 |
| Fax Number | 5036670406 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 1794 |
|
Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CS0995 | OR | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Gresham Internal Medicine Clinic by the Centers for Medicare & Medicaid Services?
The Gresham Internal Medicine Clinic has been assigned the NPI (National Provider Identifier) 1134204340 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Gresham Internal Medicine Clinic is geographically located?
The Gresham Internal Medicine Clinic is physically situated at the following location: Po Box 23200, Portland, OR, 972813200.
What is Gresham Internal Medicine Clinic's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Gresham Internal Medicine Clinic's specialized field of practice is Internal Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207R00000X.
On what date did Gresham Internal Medicine Clinic receive its 1134204340 assignment from the Centers for Medicare & Medicaid Services?
The Gresham Internal Medicine Clinic was assigned its 1134204340 on 2006-10-26, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Gresham Internal Medicine Clinic most recently updated or revised?
The details related to Gresham Internal Medicine Clinic, including its address, specialty, and other relevant information, were last updated or revised on 2008-12-11.