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General NPI Number Information
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NPI Number | 1124064506
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Entity Type | Organization
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Legal Business Name | RODNEY D MICHAELS MD PC
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 1585 LIBERTY ST SE
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City | SALEM
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State | OR
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Zip | 97302-4345
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Country | US
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Telephone | 503-589-0565
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Fax | 503-589-0463
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Provider Business Mailing Address
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Address Line | 1585 LIBERTY ST SE
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City | SALEM
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State | OR
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Zip | 97302-4345
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Country | US
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Telephone | 503-589-0565
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Fax | 503-589-0463
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Authorized Official
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Title or Position | OWNER
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Name | DR. RODNEY DOUGLAS MICHAELS
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Credential | MD
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Telephone | 503-589-0565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD16437
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License Number State | OR
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