Individual
EDGAR MAEYENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
375 PARK AVE, SUITE 5, COOS BAY, OR 97420-2242
(541) 267-7543
(541) 267-2076
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD08528
OR
Other
Enumeration date
11/07/2005
Last updated
12/05/2017
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