Gresham Internal Medicine Clinic
NPI 1134204340ActiveOrganization· Internal Medicine· Gresham, OR
Internal Medicine in Gresham, Oregon, registered in NPPES in October 2006. The authorized official on file is John M. Custis, MD, Owner/Partner.
Overview
| NPI | 1134204340 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 26, 2006 |
| Last updated in NPPES | Dec 11, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | 01794 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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