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Individual

TIMOTHY MARK ROOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-4900
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-4900

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.072962
IL
208000000X
Pediatrics Physician
125.072962
IL
208M00000X
Hospitalist Physician
Primary
MD209619
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500807433
OR
Enumeration date
06/20/2018
Last updated
07/20/2022
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