| Oregon Internal Medicine, Llc. | |
|
2380 W Main St Suite, A Medford OR 97501-2390 | |
| (541) 858-7183 | |
| Not Available |
| Full Name | Oregon Internal Medicine, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2380 W Main St, Medford, Oregon |
| Authorized Official Name and Position | Gregory Scott Grunwald (MANAGER) |
| Authorized Official Contact | 5418587183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oregon Internal Medicine, Llc. 2380 W Main St Suite, A Medford OR 97501-2390 Ph: (541) 858-7183 | Oregon Internal Medicine, Llc. 2380 W Main St Suite, A Medford OR 97501-2390 Ph: (541) 858-7183 |
| NPI Number | 1265745541 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 09/18/2015 |
| Medicare PECOS PAC ID | 9739372467 |
|---|---|
| Medicare Enrollment ID | O20101026000490 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265745541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DO22277 (Oregon) | Primary |
| Provider Name | Gregory S Grunwald |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215998679 PECOS PAC ID: 9830185107 Enrollment ID: I20051006000258 |
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