Individual
DR. CHARLES G PETRUNIN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
875 OAK ST SE, SUITE 4030, SALEM, OR 97301-3975
(503) 561-6444
(503) 561-6440
Mailing address
875 OAK ST SE, SUITE 4030, SALEM, OR 97301-3975
(503) 561-6444
(503) 561-6440
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD21956
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229284
—
OR
01
—
MD21956
OREGON LICENSE
OR
Enumeration date
10/03/2006
Last updated
07/09/2007
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