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NPI Code Detail

MEDICARE: DR. DONALD FREDERICK PLUMB MD

MEDICARE: DR. DONALD FREDERICK PLUMB MD
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
1207W00000XOphthalmology PhysicianMD07963OR

Other Identifiers

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

General Provider Information

NPI Number : 1205818267
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD FREDERICK PLUMB MD
Provider Business Mailing Address
First Line : 11086 SE OAK ST
Second Line :
City : MILWAUKIE
State : OR
Zip : 97222-6692
Country : US
Telephone Number : 503-557-2020
Fax Number : 503-344-5110
Provider Business Practice Location Address
First Line : 10819 SE STARK ST
Second Line : SUITE 200
City : PORTLAND
State : OR
Zip : 97216-3161
Country : US
Telephone Number : 503-255-2291
Fax Number : 503-252-1797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 11/17/2009

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