Provider Demographics
NPI:1164802104
Name:CROSLAND, BRIAN ADAM (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ADAM
Last Name:CROSLAND
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:ADAM
Other - Middle Name:
Other - Last Name:CROSLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-418-4200
Mailing Address - Fax:503-494-4473
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-418-4200
Practice Address - Fax:503-494-4473
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61302099207V00000X
ORMD211413207V00000X, 207VM0101X, 207VM0101X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program