- Practice location
- 9495 SW Locust St Ste G, Portland, OR 97223-6683
- Phone
- 971-314-4522
- Fax
- 971-314-4527
- Last updated
- November 27, 2024
Patan Gultawatvichai is an Internal Medicine, Hematology & Oncology based in Portland, OR. Patan Gultawatvichai practices in Portland, OR and has the professional credentials of MD. The NPI Number for Patan Gultawatvichai is 1720335987 and holds a License No. MD221300 (OR). The current practice location address for Patan Gultawatvichai is 9495 SW Locust St Ste G, Portland, OR 97223-6683 and can be reached out via phone at 971-314-4522 and via fax at 971-314-4527.
Provider Profile Details
- NPI Number
- 1720335987
- Provider Name
- Patan Gultawatvichai
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 9495 SW Locust St Ste G, Portland, OR 97223-6683
- Phone Number
- 971-314-4522
- Fax Number
- 971-314-4527
- Primary Taxonomy
- Internal Medicine, Hematology & Oncology · 207RH0003X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 7, 2012
- Last Update Date
- November 27, 2024
- Certification Date
- November 27, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 9495 SW Locust St Ste G
Portland, OR 97223-6683 - City
- Portland
- State
- Oregon
- Zip
- 97223-6683
- Phone Number
- 971-314-4522
- Fax Number
- 971-314-4527
Provider Business Mailing Address Details
- Address
- 5 Neponset St
Worcester, MA 01606-2714 - City
- Worcester
- State
- MA
- Zip
- 01606-2714
License Information
- License Number (1)
- MD221300
- License State (1)
- OR
- Taxonomy (1)
- Internal Medicine, Hematology & Oncology · 207RH0003X · Primary
- License Number (2)
- 274829
- License State (2)
- MA
- Taxonomy (2)
- Internal Medicine, Hematology & Oncology · 207RH0003X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Patan Gultawatvichai, MD?
The NPI number of Patan Gultawatvichai, MD is 1720335987. It was assigned on August 7, 2012 and is currently active in the NPPES registry.
What is the specialty of Patan Gultawatvichai, MD?
Patan Gultawatvichai, MD is registered under the primary taxonomy Internal Medicine, Hematology & Oncology (code 207RH0003X), licensed in OR under license number MD221300.
Where does Patan Gultawatvichai, MD practice?
The practice location is 9495 SW Locust St Ste G, Portland, OR 97223-6683. The office can be reached at 971-314-4522 (phone) or 971-314-4527 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1720335987 directly on the NPPES registry website.