Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | MD00048188 | WA |
N | 207V00000X | Obstetrician & Gynecologist | MD27349 | OR |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 3766401205 | UT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD00048188 | WA |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD27349 | OR |
NPI | 1033130299 |
---|---|
Provider Name | Antonio E Frias |
First Address | Portland, OR 97239-3011 |
Second Address | Portland, OR 97239-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 11/09/2021 |