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NPI Code Detail

MEDICARE: DR. HISHAM A BISMAR D.O.

MEDICARE: DR. HISHAM A BISMAR D.O.
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
1207X00000XOrthopaedic Surgery PhysicianDO28567OR

General Provider Information

NPI Number : 1477714749
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HISHAM A BISMAR D.O.
Provider Business Mailing Address
First Line : 500 NE MULTNOMAH ST STE 100
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2031
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3550 N INTERSTATE AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97227-1196
Country : US
Telephone Number : 800-813-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 04/13/2026

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