Cheryl C. Tidball Do Pc in Gresham - General Practice
Cheryl C. Tidball Do Pc - NPI 1578776670
Cheryl C. Tidball Do Pc is a General Practice in Gresham, Oregon. Cheryl C. Tidball Do Pc practices all healthcare services and medical treatments related to General Practice. The NPI Number for Cheryl C. Tidball Do Pc is 1578776670. The last update date is 2020-08-22.
Cheryl C. Tidball Do Pc's current location address is 1217 Ne Burnside Rd, Gresham, Oregon. You can contact this provider via phone number 5034890663 and fax number 5036665644. The mailing address for Cheryl C. Tidball Do Pc is 1217 Ne Burnside Rd, Gresham, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Cheryl C. Tidball Do Pc |
|---|---|
| Address | 1217 Ne Burnside Rd, Gresham, Oregon |
| Phone Number | 5034890663 |
| Fax Number | 5036665644 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN |
|---|---|
| Authorized Official Name | Tidball C. Cheryl |
| Credentials | D.O. |
| Telephone Number | 5034890663 |
NPI Number Detail
| NPI Number | 1578776670 |
|---|---|
| Provider Enumeration Date | 2007-05-07 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1217 Ne Burnside Rd |
|---|---|
| City | Gresham |
| State | Oregon (OR) |
| Post Code | 970306722 |
| Phone Number | 5034890663 |
| Fax Number | 5036665644 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
| Licence No | DO19432 |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 203778 | OR | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Cheryl C. Tidball Do Pc by the Centers for Medicare & Medicaid Services?
The Cheryl C. Tidball Do Pc has been assigned the NPI (National Provider Identifier) 1578776670 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Where is the Cheryl C. Tidball Do Pc located?
The Cheryl C. Tidball Do Pc is located at 1217 Ne Burnside Rd, Gresham, OR 970306722.
What is the Cheryl C. Tidball Do Pc's specialty and taxonomy code?
The Cheryl C. Tidball Do Pc's specialty is General Practice, and the corresponding taxonomy code is 208D00000X.
On what date did the Cheryl C. Tidball Do Pc receive its 1578776670 assignment from the Centers for Medicare & Medicaid Services?
The Cheryl C. Tidball Do Pc was assigned its 1578776670 by the Centers for Medicare & Medicaid Services on 2007-05-07.
When was the information regarding Cheryl C. Tidball Do Pc most recently updated?
The details pertaining to the Cheryl C. Tidball Do Pc, including its address, specialty, and other relevant information, were last refreshed on 2020-08-22.