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Individual

DAVID KIDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12518 NE AIRPORT WAY, PORTLAND, OR 97230-1078
(503) 256-2992
Mailing address
PO BOX 735, LAKE OSWEGO, OR 97034-0335
(503) 490-4657

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301065060
MI
207R00000X
Internal Medicine Physician
7650
NV
207R00000X
Internal Medicine Physician
G59335
CA
207R00000X
Internal Medicine Physician
MD00030390
WA
207R00000X
Internal Medicine Physician
MD13533
HI
207R00000X
Internal Medicine Physician
Primary
MD18096
OR

Other

Enumeration date
02/22/2007
Last updated
07/08/2007
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