MEDICARE: DR. RONALD ROBERT BARBOSA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	A75479	CA
2	208600000X	Surgery Physician	MD26735	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134104961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD ROBERT BARBOSA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3777
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3777
Country	:	US
Telephone Number	:	503-413-3900
Fax Number	:	503-413-3710

Provider Business Practice Location Address
First Line	:	300 N GRAHAM ST STE 125
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1683
Country	:	US
Telephone Number	:	503-413-3714
Fax Number	:	503-413-2061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	11/19/2019

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Directions to “ DR. RONALD ROBERT BARBOSA M.D.” Practice Location

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