Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 48499 | MN |
N | 207PP0204X | Pediatric Emergency Physician | 48499 | MN |
N | 208000000X | Pediatrician | 48499 | MN |
Y | 2080P0204X | Pediatric Emergency Doctor | 48499 | MN |
NPI | 1750485124 |
---|---|
Provider Name | Opher A Nadler |
First Address | Portland, OR 97239-1938 |
Second Address | Portland, OR 97239-1938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 10/07/2009 |