EDMUND GARY SERVAIS (NPI# 1477627735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477627735 |
| Entity Type | Individual |
| Full Name | EDMUND GARY SERVAIS |
| Credential | MD |
| Practice Address |
2450 12th Street Se Salem OR 97302 |
| Practice Telephone | 5033714350 |
| Practice Fax Number | 5033711124 |
| Mailing Telephone | 5033714350 |
| Mailing Fax Number | 5033711124 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 17998 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 055504 | 05 |
| Street Address |
2450 12TH STREET SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457424129 | Samuel G Farmer | Ophthalmology | 2450 12th Street Se, Salem, OR 97302 | 2006-11-17 |
| 1003989781 | Andrew C Westfall | Ophthalmology | 2450 12th Street Se, Salem, OR 97302 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528399854 | Jannet J Ung | Ophthalmology | 400 Highland Ave Ste 20, Salem, MA 01970-1783 | 2010-01-27 |
| 1356596662 | North Shore Eye Group, P.C. | Ophthalmology | 79 Highland Ave Ste 101, Salem, MA 01970-2730 | 2008-12-01 |
| 1619165891 | Fouad K. Michail | Ophthalmology | 330 Salem Woodstown Rd Rt 45, Suite 5, Salem, NJ 08079 | 2007-10-12 |
| 1528181674 | Retina Consultants, LLC | Ophthalmology | 2450 12th St Se, Salem, OR 97302-2152 | 2007-04-06 |
| 1457424129 | Samuel G Farmer | Ophthalmology | 2450 12th Street Se, Salem, OR 97302 | 2006-11-17 |
| 1558476275 | James W Long | Ophthalmology | 1020 Liberty St Se, Salem, OR 97302-4141 | 2006-08-21 |
| 1609801679 | Fouad K Michail Md Pa | Ophthalmology | Rt 45 330 Salem Woodstown Rd S 5, Salem, NJ 08079 | 2006-07-11 |
| 1396790879 | George Walton Riddick Jr. | Ophthalmology | Salem Veterans Affairs Medical Center, 1970 Roanoke Boulevard, Salem, VA 24153 | 2006-05-23 |
| 1982654968 | Jay Lee Calesnick | Ophthalmology | 261 Route 45, Salem, NJ 08079-2023 | 2006-05-11 |
| 1336111525 | Ramakrishna Gaddipati | Ophthalmology | 116 R Highland Ave, 2nd Floor, Salem, MA 01970-2923 | 2006-02-02 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.