Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD11157 | OR |
NPI | 1154399855 |
---|---|
Provider Name | Dr. Dennis M Schuelke |
First Address | Eugene, OR 97402-0451 |
Second Address | Eugene, OR 97401-3568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 09/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
236513 | (05) | OR |
C91039 | (02) |