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Organization

BEND OB-GYN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER EDWARD PALACIO MD (OWNER)
(541) 385-8050
Entity
Organization

Contact information

Practice address
2450 NE MARY ROSE PL, SUITE 220, BEND, OR 97701-7132
(541) 385-8050
(541) 385-8589
Mailing address
2450 NE MARY ROSE PL, SUITE 220, BEND, OR 97701-7132
(541) 385-8050
(541) 385-8589

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
286781
OR
Enumeration date
05/08/2006
Last updated
04/10/2008
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