Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | MD 19375 | OR |
N | 207RP1001X | Pulmonary Disease | MD19375 | OR |
NPI | 1295727535 |
---|---|
Provider Name | Richard John Maunder |
First Address | Bend, OR 97701-6015 |
Second Address | Bend, OR 97701-6015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 05/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
072561 | (05) | OR |
8574709 | (05) | WA |
A05106 | (02) | OR |