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Individual

BRETT T QUAVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
701 GOLF VIEW DR, MEDFORD, OR 97504-9643
(541) 494-1111
(541) 494-1099
Mailing address
PO BOX 8153, MEDFORD, OR 97501-0453
(541) 494-1111
(541) 494-1099

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
A75659
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD157375
OR
208VP0000X
Pain Medicine Physician
MD00048162
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500647357
MEDICAID (DMAP)
OR
05
8488843
WA
Enumeration date
06/01/2005
Last updated
10/29/2014
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