Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0001X | Clinical Cardiac Electrophysiologist | D0068927 | MD |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD154408 | OR |
NPI | 1255515938 |
---|---|
Provider Name | Fawaz Alhumaid |
First Address | Portland, OR 97216-2448 |
Second Address | Portland, OR 97216-2448 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2007 |
Last Update Date | 09/09/2014 |