Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MD159896 | OR |
NPI | 1194934307 |
---|---|
Provider Name | Robert Cecil Umberhandt |
First Address | Portland, OR 97227-1654 |
Second Address | Portland, OR 97227-1654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 01/11/2012 |