Tangum, Michael Ross

Tangum, Michael Ross is an individual health care provider with primary practice located at 1015 Nw 22Nd Ave , Portland OR 97210-3025. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tangum, Michael Ross can be contacted via phone (503) 413-7711.

Contact Information

Primary practice address
1015 Nw 22Nd Ave Portland OR 97210-3025
Phone: (503) 413-7711
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD21239 Oregon

Profile Details

NPI number 1497729321
LBN Legal business name Tangum, Michael Ross
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Sep 6th, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1497729321 NPPES
Oregon MEDICAID 133977

Popular Providers