Organization
GERALD ENGSTROM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD W ENGSTROM M.D. (OWNER)
(541) 673-3447
Entity
Organization
Contact information
Practice address
1813 W HARVARD AVE STE 427, ROSEBURG, OR 97470-8712
(541) 673-3447
(541) 677-9712
Mailing address
1813 W HARVARD AVE STE 427, ROSEBURG, OR 97470-8712
(541) 673-3447
(541) 677-9712
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD15315
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151282
—
OR
Enumeration date
01/03/2008
Last updated
01/03/2008
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