Healthcare Provider Details

I. General information

NPI: 1790281640
Provider Name (Legal Business Name): CAROLINE MARI BAGHDIKIAN-NAUSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1253 NW CANAL BLVD
REDMOND OR
97756-1334
US

IV. Provider business mailing address

2500 NE NEFF RD
BEND OR
97701-6015
US

V. Phone/Fax

Practice location:
  • Phone: 541-548-8131
  • Fax: 541-526-6608
Mailing address:
  • Phone: 541-382-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD203162
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: