Individual
MICHAEL MAZZOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4212 NE BROADWAY, MEDICAL STAFF SVCS, PORTLAND, OR 97213-1422
(503) 382-7709
(503) 382-7706
Mailing address
4212 NE BROADWAY, MEDICAL STAFF SVCS, PORTLAND, OR 97213-1422
(503) 382-7709
(503) 382-7706
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
173217
OR
Other
Enumeration date
06/21/2009
Last updated
02/01/2022
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