Individual
DAVID FERNANDO ANTEZANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST STE 359, PORTLAND, OR 97213-2983
(503) 935-8501
(503) 935-8506
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD24021
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225024052
—
WA
05
—
286392
—
OR
Enumeration date
09/27/2005
Last updated
11/22/2023
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