| Gerald Engstrom | |
|
1813 W Harvard Ave Ste 427 Roseburg OR 97470-8712 | |
| (541) 673-3447 | |
| (541) 677-9712 |
| Full Name | Gerald Engstrom |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1813 W Harvard Ave Ste 427, Roseburg, Oregon |
| Authorized Official Name and Position | Gerald W Engstrom (OWNER) |
| Authorized Official Contact | 5416733447 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald Engstrom 1813 W Harvard Ave Ste 427 Roseburg OR 97470-8712 Ph: (541) 673-3447 | Gerald Engstrom 1813 W Harvard Ave Ste 427 Roseburg OR 97470-8712 Ph: (541) 673-3447 |
| NPI Number | 1316122708 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 01/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316122708 | NPI | - | NPPES |
| 151282 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MD15315 (Oregon) | Primary |
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