Antonovic, Sandra Ana
Antonovic, Sandra Ana is an individual health care provider with primary practice located at 12442 Sw Scholls Ferry Rd Suite 205, Tigard OR 97223-0804. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Antonovic, Sandra Ana can be contacted via phone (503) 216-9140.Contact Information
Primary practice address
12442 Sw Scholls Ferry Rd Suite 205
Tigard OR 97223-0804
Phone: (503) 216-9140
Fax: (503) 216-9145
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD23792 | Oregon |
Profile Details
| NPI number | 1184773319 |
|---|---|
| LBN Legal business name | Antonovic, Sandra Ana |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Oct 13th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184773319 | NPPES |
| Oregon | MEDICAID | 272420 |
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