Individual
STEFAN MICHAEL MAMMELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8122
(503) 494-1542
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD208040
OR
208000000X
Pediatrics Physician
MDR7366
HI
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD208040
OR
Other
Enumeration date
06/26/2017
Last updated
08/01/2022
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