Individual
DR. DAVID LEE STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
(541) 282-6559
(541) 282-6710
Mailing address
520 MEDICAL CENTER DR, STE 300, MEDFORD, OR 97504-4316
(541) 282-6559
(541) 282-6710
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD15510
OR
2086S0129X
Vascular Surgery Physician
MD15510
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02WCGFLB
MEDICARE
OR
05
—
212720
—
OR
01
—
4898006
BLUE CROSS
OR
Enumeration date
10/17/2006
Last updated
03/21/2023
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