Douglas Chester Gruzd, MD | |
1201 Ne Elm, Prineville, OR 97754 | |
(541) 447-6254 | |
(541) 447-2511 |
Full Name | Douglas Chester Gruzd |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 1201 Ne Elm, Prineville, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043246069 | NPI | - | NPPES |
227046 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD24514 (Washington) | Primary |
Entity Name | St Charles Health System Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982621447 PECOS PAC ID: 3870402852 Enrollment ID: O20040112000045 |
Mailing Address | Practice Location Address |
---|---|
Douglas Chester Gruzd, MD 505 S 336th St, Suite 600, Federal Way, WA 98003-6328 Ph: (253) 838-6180 | Douglas Chester Gruzd, MD 1201 Ne Elm, Prineville, OR 97754 Ph: (541) 447-6254 |
Dr. Brian William Lane, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1201 N Elm, Prineville, OR 97754 Phone: 541-447-6254 | |
Barrett Jereme Woodhall, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1201 Ne Elm St, Prineville, OR 97754 Phone: 541-447-6254 | |
Dr. Daniel S Ballin, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1201 N Elm, Prineville, OR 97754 Phone: 541-447-6254 | |
David Ernest Magaret, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1201 Ne Elm St, Prineville, OR 97754 Phone: 541-447-6254 Fax: 541-447-2511 |