Bhutta, Omar J
Bhutta, Omar J is an individual health care provider with primary practice located at 2801 N Gantenbein Ave , Portland OR 97227-1623. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is his primary health care specialty. Bhutta, Omar J can be contacted via phone (503) 276-6565.Contact Information
Primary practice address
2801 N Gantenbein Ave
Portland OR 97227-1623
Phone: (503) 276-6565
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ML20008350 | Washington |
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | LT-3189 | New Hampshire |
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | 15905 | New Hampshire |
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | MD174110 | Oregon |
Profile Details
NPI number | 1033122502 |
---|---|
LBN Legal business name | Bhutta, Omar J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 14th, 2006 |
Last updated | Dec 7th, 2022 - 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1033122502 | NPPES |
New Hampshire | MEDICAID | 32001711 | |
New Hampshire | MEDICAID | 500693056 | |
New Hampshire | MEDICAID | 1021010 |
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