Healthcare Provider Details

I. General information

NPI: 1235108929
Provider Name (Legal Business Name): ADAM BARMADA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N GRAHAM ST SUITE 200
PORTLAND OR
97227-1654
US

IV. Provider business mailing address

501 N GRAHAM ST SUITE 200
PORTLAND OR
97227-1654
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-4488
  • Fax: 503-413-1812
Mailing address:
  • Phone: 503-413-4488
  • Fax: 503-413-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberMD23796
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: