Individual
GAJANAN NILAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10202 SE 32ND AVE, SUITE 703, PORTLAND, OR 97222-3610
(503) 513-8020
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD14509
OR
2084N0400X
Neurology Physician
MD14509
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130708
—
OR
01
—
P00479379
RR MEDICARE
OR
Enumeration date
05/08/2006
Last updated
10/08/2012
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