Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 246917 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD13036 | RI |
N | 207RC0000X | Internist - Cardiovascular Disease | MD159484 | OR |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD159484 | OR |
NPI | 1184849762 |
---|---|
Provider Name | Scott C Brancato |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97225-6652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500646436 | (05) | OR |
P01131271 | RR MEDICARE (PH&S) (01) | OR |