Antiochos, Brendan B

Antiochos, Brendan B is an individual health care provider with primary practice located at 9205 Sw Barnes Road 1St Floor, Portland OR 97225-6603. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Antiochos, Brendan B can be contacted via phone (503) 216-2906.

Contact Information

Primary practice address
9205 Sw Barnes Road 1St Floor Portland OR 97225-6603
Phone: (503) 216-2906
Fax: (503) 216-4114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD155471 Oregon
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD155471 Oregon

Profile Details

NPI number 1174799092
LBN Legal business name Antiochos, Brendan B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2008
Last updated Jan 9th, 2012 - about 13 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 1174799092 NPPES
Oregon MEDICAID 500639268

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