Individual
DR. ALEXANDER DEMETRE NICOLOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 N GRAHAM ST, SUITE 415, PORTLAND, OR 97227-1654
(503) 413-3580
(503) 413-3578
Mailing address
501 N GRAHAM ST, SUITE 415, PORTLAND, OR 97227-1654
(503) 413-3580
(503) 413-3578
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
18926
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226934
—
OR
Enumeration date
02/28/2006
Last updated
07/16/2007
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