Individual
ANTONY MATHEW POOTHULLIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 331-6330
Mailing address
3600 N INTERSTATE AVE, PORTLAND, OR 97227-1106
(503) 331-6330
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD00045365
WA
207W00000X
Ophthalmology Physician
Primary
MD25979
OR
Other
Enumeration date
09/20/2006
Last updated
02/04/2022
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