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Individual

GREGG R MCCORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10123 SE MARKET ST, PORTLAND, OR 97216-2532
(503) 257-2500
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD160836
OR
208M00000X
Hospitalist Physician
Primary
MD160836
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500666183
OR
Enumeration date
06/27/2011
Last updated
06/08/2017
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