Individual
DR. THOMAS ROBERT DUNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10373 NE HANCOCK ST, SUITE115, PORTLAND, OR 97220-3873
(503) 853-8631
(503) 853-8636
Mailing address
10373 NE HANCOCK ST, SUITE115, PORTLAND, OR 97220-3873
(503) 853-8631
(503) 853-8636
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD09111
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047225
—
OR
01
—
139407
MEDICARE PTAN
—
01
—
R139365
CLINIC MEDICARE PIN
OR
Enumeration date
12/26/2006
Last updated
01/04/2008
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