MEDICARE: DR. MIRIAM ELIZABETH CHOATE M.D./M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DR49311	CO
2	207Q00000X	Family Medicine Physician	MD157695	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225272651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRIAM ELIZABETH CHOATE M.D./M.P.H.

Provider Business Mailing Address
First Line	:	PO BOX 3158
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3158
Country	:	US
Telephone Number	:	541-732-7460
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 ROYAL AVE UNIT 350
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97504-6194
Country	:	US
Telephone Number	:	541-732-7460
Fax Number	:	541-826-5843

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2009
Last Update Date	:	06/14/2022

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