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Individual

DR. BASHEER AHAMAD KUMMANGAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8311

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.027492
OH
207RN0300X
Nephrology Physician
Primary
MD224247
OR

Other

Enumeration date
06/27/2016
Last updated
07/09/2025
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