Provider Information for 1972762490
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Mr. MOHAMMAD A BADER L.PC
Sex: Male
NPI: 1972762490
Last Updated: 2008-06-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1972762490 | ||||||||
| Enumeration Date | 2008-06-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 423 NE 60TH AVE PORTLAND, OR 97213-3725 United States Phone: 503-475-8676 | Fax: | ||||||||
| Primary Practice Address | 423 NE 60TH AVE PORTLAND, OR 97213-3725 United States Phone: 503-475-8676 | Fax: | ||||||||
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