Individual
CHARLES JOSEPH BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 SW VERMONT ST, PORTLAND, OR 97219-1940
(503) 452-0915
(503) 768-9232
Mailing address
2400 SW VERMONT ST, PORTLAND, OR 97219-1940
(503) 452-0915
(503) 768-9232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD16068
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006739
—
OR
01
—
P00206903
RR MEDICARE
OR
Enumeration date
06/28/2006
Last updated
03/15/2011
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