GRESHAM PODIATRY CENTER LLC NPI 1891742318

NPI Information

GRESHAM PODIATRY CENTER, LLC is a foot and ankle surgery podiatrist in Gresham, OR. GRESHAM PODIATRY CENTER, LLC NPI is 1891742318. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

831 NW COUNCIL DR
SUITE #203
GRESHAM, OR
ZIP 97030-721
Phone: (503) 667-6600
Fax: (503) 667-6608

The provider's authorized official is Derek John Mccammon .
The authorized official title is Owner and has the following contact phone number (503) 667-6600.

The enumeration date for this NPI number is 5/28/2006 and was last updated on 4/2/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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