Individual
RICHARD DE QUIROZ BASILAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2720 COMMERCIAL ST SE, SUITE #201, SALEM, OR 97302-4495
(503) 540-9999
Mailing address
2720 COMMERCIAL ST SE, SUITE #201, SALEM, OR 97302-4495
(503) 540-9999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005012151
MO
207RI0200X
Infectious Disease Physician
Primary
MD154343
OR
Other
Enumeration date
10/05/2006
Last updated
07/27/2016
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