Individual
DR. MICHAEL PAUL GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19260 SW 65TH AVE, SUITE 400, TUALATIN, OR 97062-5701
(503) 692-1200
(503) 692-1220
Mailing address
19260 SW 65TH AVE, SUITE 400, TUALATIN, OR 97062-5701
(503) 692-1200
(503) 692-1220
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD22270
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288387
OMAP NUMBER
OR
05
—
288387
—
OR
Enumeration date
04/22/2006
Last updated
03/09/2010
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