Provider Demographics
NPI:1528046455
Name:STRUTIN, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:STRUTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:929 SW SIMPSON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3599
Mailing Address - Country:US
Mailing Address - Phone:541-389-7741
Mailing Address - Fax:541-278-8375
Practice Address - Street 1:920 COUNTRY CLUB RD
Practice Address - Street 2:STE 200A
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6024
Practice Address - Country:US
Practice Address - Phone:541-342-2134
Practice Address - Fax:541-686-6021
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-01-03
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Provider Licenses
StateLicense IDTaxonomies
ORMD13948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR101204Medicaid
OR101204Medicaid
R158187Medicare PIN