Individual
MICHAEL PAUL PETROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-7500
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-7500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301107913
MI
207P00000X
Emergency Medicine Physician
Primary
MD192052
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2015
Last updated
07/03/2019
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