Shivalingappa, Samudyatha

Shivalingappa, Samudyatha is an individual health care provider with primary practice located at 15700 Sw Greystone Ct , Beaverton OR 97006-6011. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Shivalingappa, Samudyatha can be contacted via phone (971) 262-9150.

Contact Information

Primary practice address
15700 Sw Greystone Ct Beaverton OR 97006-6011
Phone: (971) 262-9150
Fax: (971) 262-9151
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD23979 Oregon
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X MD23979 Oregon

Profile Details

NPI number 1841286960
LBN Legal business name Shivalingappa, Samudyatha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Dec 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 1841286960 NPPES
Oregon MEDICAID 117023

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