Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD08774 | OR |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD08774 | OR |
NPI | 1336118561 |
---|---|
Provider Name | David L Noall |
First Address | Portland, OR 97227-1654 |
Second Address | Portland, OR 97227-1654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 25/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
230888 | (05) | OR |
C90985 | (02) | OR |