Individual
DR. ANDRES GONZALO ZULETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 CAPITOL ST NE, SALEM, OR 97301-0698
(503) 399-2424
(503) 375-7429
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
(503) 375-7429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
053530
CT
207Q00000X
Family Medicine Physician
272646
NY
207Q00000X
Family Medicine Physician
L.3596R
AL
207Q00000X
Family Medicine Physician
Primary
MD191405
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500762457
—
OR
Enumeration date
08/03/2010
Last updated
06/13/2019
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