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Individual

JEREMIAH ANDREW ALT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D.

Contact information

Practice address
3303 SW BOND AVE # CH5E, PORTLAND, OR 97239-3098
(503) 494-5678
(503) 494-4631
Mailing address
3303 SW BOND AVE # CH5E, PORTLAND, OR 97239-3098
(503) 494-5678
(503) 494-4631

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD156611
OR
208600000X
Surgery Physician
TRN11153
FL

Other

Enumeration date
06/07/2007
Last updated
10/16/2021
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