Antezana, David Fernando

Antezana, David Fernando is an individual health care provider with primary practice located at 5050 Ne Hoyt St Ste 359 , Portland OR 97213-2983. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Antezana, David Fernando can be contacted via phone (503) 935-8501.

Contact Information

Primary practice address
5050 Ne Hoyt St Ste 359 Portland OR 97213-2983
Phone: (503) 935-8501
Fax: (503) 935-8506
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X MD24021 Oregon

Profile Details

NPI number 1225024052
LBN Legal business name Antezana, David Fernando
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Nov 22nd, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225024052 NPPES
Washington MEDICAID 1225024052
Washington MEDICAID 286392

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