David A Deardorff MD

NPI 1093749442 - Family Medicine - 207Q00000X

NPI Details
NPI 1093749442
Gender Male
Enumeration Date 07/10/2006
Last Updated 04/13/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
4805 NE GLISAN ST
SUITE BG05
PORTLAND OR, 97213-2933, US
Phone (503) 215-2392
Fax (503) 215-6918
Business Location
PO BOX 3158
PORTLAND OR, 97208-3158, US
Phone (503) 215-6494
Fax (503) 215-6644
Toxanomy
Taxonomy Code 207Q00000X
License State Oregon
License Number MD23422
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According to our database, David A Deardorff MD NPI is 1093749442, taxonomy code is 207Q00000X and license number is MD23422, license state is located at Oregon. David A Deardorff MD physically located at 4805 Ne Glisan St, Portland OR, 97213-2933. NPI Number David A Deardorff MD has the Individual type.

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1093749442 NPI number is provided on an as is basis without warranty of any kind. 1093749442 is maintained by the National Plan & Provider Enumeration System. The contents of David A Deardorff MD are for informational purposes only.