| Dr Michael Paul Gardner, MD | |
|
19260 Sw 65th Ave, Suite 400, Tualatin, OR 97062-5701 | |
| (503) 692-1200 | |
| (503) 692-1220 |
| Full Name | Dr Michael Paul Gardner |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 31 Years |
| Location | 19260 Sw 65th Ave, Tualatin, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215993845 | NPI | - | NPPES |
| 288387 | Other | OR | OMAP NUMBER |
| 288387 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MD22270 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Medical Center | Roseburg, OR | Hospital |
| Legacy Meridian Park Medical Center | Tualatin, OR | Hospital |
| Entity Name | Michael P Gardner Md Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437330180 PECOS PAC ID: 9739261702 Enrollment ID: O20080129000785 |
| Entity Name | Centennial Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518103274 PECOS PAC ID: 6103982962 Enrollment ID: O20090303000063 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Paul Gardner, MD 19260 Sw 65th Ave, Suite 400, Tualatin, OR 97062-5701 Ph: (503) 692-1200 | Dr Michael Paul Gardner, MD 19260 Sw 65th Ave, Suite 400, Tualatin, OR 97062-5701 Ph: (503) 692-1200 |
Dr. Gregory A Cost, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19250 Sw 65th Ave, Suite 235, Tualatin, OR 97062 Phone: 503-692-4820 Fax: 503-612-0793 | |
Dr. David Andrew Staneck, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 12205 Sw Tualatin Rd Ste 100, Tualatin, OR 97062 Phone: 503-223-6223 Fax: 503-223-3665 |