Individual
DR. CHARLES KRISTIAN ENESTVEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, DEPARTMENT OF SURGICAL ONCOLOGY, L619, PORTLAND, OR 97239-3011
(503) 494-8592
Mailing address
3181 SW SAM JACKSON PARK RD, L619, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
MD151458
OR
2086X0206X
Surgical Oncology Physician
MD151458
OR
Other
Enumeration date
05/23/2007
Last updated
07/21/2010
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