Individual
PETER S FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHARMD
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-3442
(503) 494-5330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD215294
OR
207RN0300X
Nephrology Physician
Primary
MD215294
OR
Other
Enumeration date
08/27/2011
Last updated
05/02/2024
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