Organization
GAPS HEALTH OR PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NITISH KOSARAJU MD (PHYSICIAN)
(832) 628-9774
Entity
Organization
Contact information
Practice address
780 COMMERCIAL ST SE STE 100, SALEM, OR 97301-3465
(503) 588-5767
Mailing address
PO BOX 208003, DALLAS, TX 75320-8003
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/15/2019
Last updated
11/15/2019
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