Individual
MICHAEL A. FORTUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 NW SAMARITAN DR, GOOD SAMARITAN REGIONAL MEDICAL CENTER, CORVALLIS, OR 97330-3737
(541) 768-5572
(541) 768-5047
Mailing address
7635 NW MCDONALD CIR, CORVALLIS, OR 97330-9544
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD14008
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060186
—
OR
Enumeration date
03/28/2007
Last updated
05/13/2008
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