Servais, Edmund Gary
Servais, Edmund Gary is an individual health care provider with primary practice located at 2450 12Th Street Se , Salem OR 97302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Servais, Edmund Gary can be contacted via phone (503) 371-4350.Contact Information
Primary practice address
2450 12Th Street Se
Salem OR 97302
Phone: (503) 371-4350
Fax: (503) 371-1124
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 17998 | Oregon |
Profile Details
| NPI number | 1477627735 |
|---|---|
| LBN Legal business name | Servais, Edmund Gary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477627735 | NPPES |
| Oregon | MEDICAID | 055504 |
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