Provider Demographics
NPI:1821239310
Name:MENDEZ-ALLWOOD, DANIEL EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EDUARDO
Last Name:MENDEZ-ALLWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 OAK ST SE STE 4030
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3984
Mailing Address - Country:US
Mailing Address - Phone:503-561-6444
Mailing Address - Fax:503-561-6442
Practice Address - Street 1:3025 RYAN DR SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-5057
Practice Address - Country:US
Practice Address - Phone:503-485-0350
Practice Address - Fax:503-561-6442
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00778207R00000X
ORMD157651207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500648035Medicaid
ORR165501Medicare PIN