Individual
KISHORE GOPINATHAN PATHIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2397 NE CUMULUS AVE, MCMINNVILLE, OR 97128-6257
(503) 472-5163
Mailing address
2397 NE CUMULUS AVE, MCMINNVILLE, OR 97128-6257
(503) 472-5163
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
695279-1
OR
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
695279-1
OR
207RP1001X
Pulmonary Disease Physician
Primary
695279-1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055884
—
OR
Enumeration date
07/21/2006
Last updated
08/21/2013
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