Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD14983 | OR |
NPI | 1487720710 |
---|---|
Provider Name | Dr. Eugene M. Stoelk |
First Address | West Linn, OR 97068-2266 |
Second Address | Portland, OR 97201-5128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |