Individual
ADAM MIZGAJSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2906
(503) 216-7106
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD25223
OR
208M00000X
Hospitalist Physician
Primary
MD25223
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
233191
—
OR
01
—
P00451458
RR MEDICARE
OR
Enumeration date
06/25/2006
Last updated
07/27/2021
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