Individual
QUTAIBAH SABHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
890 OAK ST SE # OR, SALEM, OR 97301-3905
(503) 561-5200
Mailing address
890 OAK ST SE, SALEM, OR 97301-3905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD210251
OR
208M00000X
Hospitalist Physician
Primary
MD210251
OR
Other
Enumeration date
07/04/2019
Last updated
08/19/2022
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