Provider Demographics
NPI:1407038342
Name:DREYER, CYNTHIA A (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:DREYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6019
Mailing Address - Country:US
Mailing Address - Phone:541-683-0878
Mailing Address - Fax:
Practice Address - Street 1:743 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6019
Practice Address - Country:US
Practice Address - Phone:541-683-0878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13787207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR191759Medicaid
ORC83572Medicare UPIN
ORR120213Medicare PIN