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General NPI Number Information
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NPI Number | 1447395710
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Entity Type | Individual
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Provider Name | MICHAEL PUERINI MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3405 DEER PARK DR SE
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City | SALEM
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State | OR
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Zip | 97310-9302
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Country | US
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Telephone | 503-373-0168
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Fax | 503-378-6732
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Provider Business Mailing Address
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Address Line | 3405 DEER PARK DR SE
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City | SALEM
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State | OR
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Zip | 97310-9302
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Country | US
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Telephone | 503-373-0168
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Fax | 503-378-6732
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MD 15096
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License Number State | OR
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