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Individual

OMAR J BHUTTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 276-6565
Mailing address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 276-6565

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ML20008350
WA
2080P0203X
Pediatric Critical Care Medicine Physician
15905
NH
2080P0203X
Pediatric Critical Care Medicine Physician
LT-3189
NH
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD174110
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021010
VT
05
32001711
NH
05
500693056
OR
Enumeration date
08/14/2006
Last updated
12/07/2022
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