Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2010019219 | MO |
N | 111NI0900X | Internist | 2010019219 | MO |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | AZ54621 | AZ |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD197753 | OR |
Y | 207RC0000X | Internist - Cardiovascular Disease | MD197753 | OR |
NPI | 1427379825 |
---|---|
Provider Name | Dr. Sophia E Airhart |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97225-6612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2010 |
Last Update Date | 04/06/2021 |