Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | L4482SP | AL |
Y | 207U00000X | Nuclear Medicine Specialist | MD203606 | OR |
NPI | 1487094157 |
---|---|
Provider Name | Dr. Gagandeep Choudhary |
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 | 26/06/2013 |
Last Update Date | 02/06/2021 |