1407062037 NPI number — DR. ROBERT ARTHUR DA PRATO M.D.

Table of content: DR. ROBERT ARTHUR DA PRATO M.D. (NPI 1407062037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407062037 NPI number — DR. ROBERT ARTHUR DA PRATO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DA PRATO
Provider First Name:
ROBERT
Provider Middle Name:
ARTHUR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407062037
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8312 NW HAWKINS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97229-8492
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-292-3723
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7545 NE AMBASSADOR PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97220-1367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-528-1630
Provider Business Practice Location Address Fax Number:
503-528-1641
Provider Enumeration Date:
05/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 202C00000X , with the licence number:  MD22859 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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