Organization
INTERNAL MEDICINE ASSOCIATES OF PORTLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. F. WILLIAM MILLER M.D. (OWNER)
(503) 853-8631
Entity
Organization
Contact information
Practice address
10373 NE HANCOCK ST, SUITE 115, PORTLAND, OR 97220-3873
(503) 853-8631
(503) 853-8636
Mailing address
10373 NE HANCOCK ST, SUITE 115, PORTLAND, OR 97220-3873
(503) 853-8631
(503) 853-8636
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD08175
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139365
MEDICARE PTAN
—
Enumeration date
09/25/2007
Last updated
01/04/2008
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