Wyman, Michael Bruce
Wyman, Michael Bruce is an individual health care provider with primary practice located at 5050 Ne Hoyt St Suite 340, Portland OR 97213-2991. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wyman, Michael Bruce can be contacted via phone (503) 234-9861.Contact Information
Primary practice address
5050 Ne Hoyt St Suite 340
Portland OR 97213-2991
Phone: (503) 234-9861
Fax: (503) 238-0873
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD13922 | Oregon |
Profile Details
| NPI number | 1104824648 |
|---|---|
| LBN Legal business name | Wyman, Michael Bruce |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 8th, 2005 |
| Last updated | Dec 31st, 2007 - about 18 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 | 1104824648 | NPPES |
| Oregon | MEDICAID | 202739 |
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