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General NPI Number Information
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NPI Number | 1376788315
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Entity Type | Organization
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Legal Business Name | MICHELLE L. MEARS, MD , P.C
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 12/04/2008
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Provider Practice Location Address
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Address Line | 10395 NW GLENCOE RD SUITE 200
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City | NORTH PLAINS
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State | OR
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Zip | 97133-8208
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Country | US
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Telephone | 503-647-9400
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Fax | 503-647-5120
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Provider Business Mailing Address
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Address Line | 10395 NW GLENCOE RD SUITE 200
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City | NORTH PLAINS
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State | OR
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Zip | 97133-8208
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Country | US
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Telephone | 503-647-9400
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Fax | 503-647-5120
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE L MEARS
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Credential | M.D.
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Telephone | 503-647-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD19086
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License Number State | OR
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