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DR. JONATHAN BLAIR EDMISTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 706-6892
(541) 706-6813
Mailing address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
289259
MA
207R00000X
Internal Medicine Physician
Primary
289259
MA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/07/2018
Last updated
11/01/2022
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