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:
Health care specialties
| Specialty | Code | License # | 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 14 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 | 1497729321 | NPPES |
| Oregon | MEDICAID | 133977 |
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