Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD10584 | OR |
NPI | 1295004075 |
---|---|
Provider Name | Dr. Leon Speroff |
First Address | Portland, OR 97231-2403 |
Second Address | Portland, OR 97231-2403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2011 |
Last Update Date | 22/12/2011 |