Individual
DR. ROBERT J AZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25050 SE STARK ST STE 265, GRESHAM, OR 97030-3388
(503) 674-1520
(503) 674-1599
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD18386
OR
2086S0129X
Vascular Surgery Physician
MD18386
OR
208C00000X
Colon & Rectal Surgery Physician
MD18386
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151335
—
OR
01
—
P00965924
RR MEDICARE - PROVIDENCE
OR
Enumeration date
12/07/2005
Last updated
09/25/2019
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