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Individual

DOMINIK GRZEGORZ SOKALSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1365 POPLAR DR, MEDFORD, OR 97504-5207
(541) 773-2233
(541) 773-7089
Mailing address
1365 POPLAR DR, MEDFORD, OR 97504-5207
(541) 773-4291
(541) 773-4291

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
56254
CO
207RR0500X
Rheumatology Physician
Primary
MD153128
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
478052ZL1P
MEDICARE CO
CO
05
500722930
OR
01
DR.0056254
STATE LICENSE
CO
01
MD153128
STATE LICENSE
OR
01
R194430
MEDICARE OR
OR
Enumeration date
07/25/2007
Last updated
02/11/2019
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