Individual
RAYMOND M BACULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1165 UNION ST NE, SALEM, OR 97301-4693
(503) 399-2424
(503) 375-7429
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
(503) 375-7429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL15205
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213671
—
OR
01
—
CS4159
RAILROAD MEDICARE GROUP
—
01
—
P00791781
RAILROAD MEDICARE
—
Enumeration date
06/10/2006
Last updated
12/19/2016
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