Individual
PAUL ROSTYKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
280 MAPLE ST, ASHLAND, OR 97520-1552
(541) 201-4100
(541) 488-7434
Mailing address
PO BOX 34935, DEPARTMENT 563, SEATTLE, WA 98124-1935
(888) 633-0079
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD15433
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023507000
BC/BS OF OREGON
—
05
—
170084
—
OR
01
—
930079052
RAILROAD MEDICARE
—
01
—
97520A006
CHAMPUS
—
01
—
B42699
GROUP HEALTH
—
01
—
XPY185097
MEDI CAL
—
Enumeration date
04/04/2006
Last updated
02/21/2011
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