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General NPI Number Information
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NPI Number | 1053576868
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Entity Type | Organization
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Legal Business Name | UMPQUA INTERNAL MEDICINE,P.C.
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 2510 NW EDENBOWER BLVD SUITE 176
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City | ROSEBURG
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State | OR
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Zip | 97471-8899
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Country | US
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Telephone | 541-673-2254
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 NW EDENBOWER BLVD SUITE 176
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City | ROSEBURG
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State | OR
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Zip | 97471-8899
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Country | US
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Telephone | 541-673-2254
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | RODICA TOTOIAN
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Credential |
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Telephone | 541-378-8461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | MD24774
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License Number State | OR
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