Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD25711 | OR |
Y | 208600000X | Surgeon | MD25711 | OR |
N | 2082S0105X | Plastic Hand Surgeon | MD25711 | OR |
NPI | 1962464222 |
---|---|
Provider Name | Dr. David Garth Meldrum |
First Address | Eugene, OR 97401-6624 |
Second Address | Eugene, OR 97401-6624 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 11/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
269810 | (05) | OR |