Individual
DR. MICHAEL ERIC BALKOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 515, PORTLAND, OR 97213-2991
(503) 236-7743
(503) 236-7031
Mailing address
5050 NE HOYT ST, SUITE 515, PORTLAND, OR 97213-2991
(503) 236-7743
(503) 236-7031
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD13984
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221762
—
OR
Enumeration date
11/29/2006
Last updated
12/30/2016
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