John M Custis, MD

NPI #1770561813 in Gresham, Oregon

Provider Information

NPI Number
1770561813
Entity Type
Individual
Name
John M Custis, MD
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Internal Medicine
Credential
MD
Enumeration Date
Jan 9, 2006
Last Updated
Dec 21, 2007

Practice Location

Address
24900 SE STARK
Address 2
STE 109
State
Oregon
ZIP Code
97030
Phone
(503) 667-1015

Specialties & Taxonomy Codes

Specialty
Internal Medicine

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