| Firehouse Diabetes & Endocrine Center | |
|
1585 Liberty St Se Salem OR 97302-4345 | |
| (503) 589-0565 | |
| (503) 589-0463 |
| Full Name | Firehouse Diabetes & Endocrine Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1585 Liberty St Se, Salem, Oregon |
| Authorized Official Name and Position | Rodney Douglas Michaels (OWNER) |
| Authorized Official Contact | 5035890565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Firehouse Diabetes & Endocrine Center 1585 Liberty St Se Salem OR 97302-4345 Ph: (503) 589-0565 | Firehouse Diabetes & Endocrine Center 1585 Liberty St Se Salem OR 97302-4345 Ph: (503) 589-0565 |
| NPI Number | 1124064506 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 07/16/2010 |
| Medicare PECOS PAC ID | 6901878032 |
|---|---|
| Medicare Enrollment ID | O20040810000534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124064506 | NPI | - | NPPES |
| 1386691061 | Other | DR MICHAELS NPI | |
| 058292 | Medicaid | OR | |
| 1699715227 | Other | BARBARA BRITSCH NPI | |
| 137534 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | MD16437 (Oregon) | Primary |
| Provider Name | Rodney Douglas Michaels |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1386691061 PECOS PAC ID: 5698955433 Enrollment ID: I20110210000600 |
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