Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD201467 | OR |
NPI | 1053666131 |
---|---|
Provider Name | Dr. Rahul Singh |
First Address | Portland, OR 97232-2686 |
Second Address | Portland, OR 97225-6631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 12/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500782752 | (05) | OR |