Individual
DAVID RUSSELL PETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6640 SW REDWOOD LANE, PORTLAND, OR 97224
(503) 620-7358
(503) 221-4451
Mailing address
6640 SW REDWOOD LANE, PORTLAND, OR 97224
(503) 620-7358
(503) 221-4451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18632
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
058268
—
OR
Enumeration date
09/27/2006
Last updated
07/08/2007
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