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Individual

JAMES MARK EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7810
Mailing address
3181 SW SAM JACKSON PARK RD, OHSU VASCULAR SURGERY, OP-11, PORTLAND, OR 97239-3011

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD13102
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
212274
OR
Enumeration date
09/20/2006
Last updated
07/21/2007
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