Individual
DR. MICHAEL DAVID FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1015 NW 22ND AVE # 230, PORTLAND, OR 97210-3025
(503) 413-7711
Mailing address
1015 NW 22ND AVE # 230, PORTLAND, OR 97210-3025
(503) 413-7711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO192476
OR
390200000X
Student in an Organized Health Care Education/Training Program
PG177909
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
12/09/2015
Last updated
06/26/2019
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