Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

John M Custis, MD

Individual provider Internal Medicine Physician · NPI 1770561813

John M Custis, MD is an Internal Medicine Physician in Gresham, Oregon. Licensed in Oregon. Registered with an NPI since 2006.

Licensed in
OR
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

24900 SE Stark Ste 109
Gresham, OR 97030
Phone: (503) 667-1015
Fax: (503) 667-0406
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD09069 (OR)

Record details

NPI number1770561813
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 9, 2006
Last updated in NPPESDecember 21, 2007
Mailing addressPo Box 23200, Portland, OR 97281-3200

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