Individual
DR. KIMBERLY SUSAN STUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 STATE ST, SALEM, OR 97301-3922
(503) 370-6062
Mailing address
5536 SALAL ST SE, SALEM, OR 97306-2184
(214) 418-3699
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD194544
OR
207Q00000X
Family Medicine Physician
P1496
TX
390200000X
Student in an Organized Health Care Education/Training Program
RT1676
NH
Other
Enumeration date
06/28/2007
Last updated
09/29/2021
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