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Individual

MR. MICHAEL R. MCCLUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5050 NE HOYT ST, SUITE 651, PORTLAND, OR 97213-2991
(503) 215-6586
(503) 215-6428
Mailing address
417 SW 117TH AVE, SUITE 120, PORTLAND, OR 97225-5924
(503) 641-7173
(503) 641-5254

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD10002
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
042267
OR
Enumeration date
06/27/2006
Last updated
10/18/2007
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