National Provider Identifier Database

KYLE M BALTRUSCH, MD – NPI #1952741779
Plastic and Reconstructive Surgery


Contact Information

KYLE M BALTRUSCH, MD
1200 NW NAITO PKWY STE 310
PORTLAND, OR97209-2829
Phone: 503-292-9200
Fax: 503-292-9205
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for KYLE M BALTRUSCH

NPI Number 1952741779
Credentials MD
Entity Individual
Enumeration date 06/25/2013
Last updated 07/19/2021 - About 5 years ago
Sole proprietor1 No
Identifiers
  • OR License #: MD205639
  • OR Medicaid: 500688755
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for KYLE M BALTRUSCH, MD

There are currently no reviews for KYLE M BALTRUSCH, MD


NPIdb - Home
v2.201