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Individual

CHARLES DAVID CULBERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-6205
Mailing address
922 NW 11TH AVE, #1102, PORTLAND, OR 97209-2776
(503) 262-8393

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
DO24952
OR
208M00000X
Hospitalist Physician
Primary
DO24952
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
029027
OR
Enumeration date
03/24/2006
Last updated
03/24/2011
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