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Individual

MR. MICAIAH MATTHEW KUZMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5900 INLAND SHORES WAY, KEIZER, OR 97303
(503) 399-2424
(503) 589-6240
Mailing address
2020 CAPITOL STREET NE, SALEM, OR 97301
(503) 399-2424
(503) 589-6240

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
152066
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500624513
OR
01
P00866340
RAILROAD MEDICARE
OR
Enumeration date
10/26/2006
Last updated
04/25/2013
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