Individual
CHARLES LAWRENCE CROTEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5050 NE HOYT ST STE 625, PORTLAND, OR 97213-2990
(503) 731-2900
Mailing address
5050 NE HOYT ST STE 625, PORTLAND, OR 97213-2990
(503) 731-2900
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
34011489
OH
2085R0202X
Diagnostic Radiology Physician
5101016089
MI
2085R0202X
Diagnostic Radiology Physician
Primary
DO218394
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518183284
—
MI
01
—
34011489
OHIO MEDICAL LICENSE
OH
01
—
5101016089
MICHIGAN MEDICAL LICENSE
MI
01
—
DO218394
OREGON MEDICAL LICENSE
OR
05
—
PENDING
—
OH
Enumeration date
04/18/2007
Last updated
03/19/2024
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