Provider Demographics
NPI:1215905039
Name:BRUTON, ORIN H (MD)
Entity type:Individual
Prefix:
First Name:ORIN
Middle Name:H
Last Name:BRUTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:875 OAK ST SE
Mailing Address - Street 2:SUITE 5080
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3975
Mailing Address - Country:US
Mailing Address - Phone:503-485-4787
Mailing Address - Fax:503-485-4789
Practice Address - Street 1:875 OAK ST SE
Practice Address - Street 2:SUITE 5080
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3975
Practice Address - Country:US
Practice Address - Phone:503-485-4787
Practice Address - Fax:503-485-4789
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD08882207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR014399Medicaid
ORP00204790OtherRAILROAD MEDICARE
ORC91305Medicare UPIN
OR014399Medicaid