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-- JOHN M CUSTIS -- MD

Individual Provider (NPI-1) Active

Internal Medicine

Provider Information

NPI Number
1770561813
Provider Type
Individual Provider (NPI-1)
Credentials
MD
Status
Active

Contact & Location

Address
24900 SE STARK STE 109, GRESHAM, OR, 97030
Phone
(503) 667-1015
Fax
(503) 667-0406

Specialties & Taxonomies

Internal Medicine Primary License: OR #MD09069

All Addresses

LOCATION

24900 SE STARK STE 109

GRESHAM, OR, 97030

(503) 667-1015

MAILING

PO BOX 23200

PORTLAND, OR, 972813200

(503) 667-1015