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Individual

MICHELLE PETROFES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
620 RANCH RD, REEDSPORT, OR 97467-1720
(541) 271-2163
(541) 271-4058
Mailing address
620 RANCH RD, REEDSPORT, OR 97467-1720
(541) 271-2163
(541) 271-4058

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD14685
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
276263
OR
Enumeration date
07/06/2006
Last updated
12/04/2014
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