Individual
DR. MICHAEL ANDREW O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4805 NE GLISAN ST, SUITE BG05, PORTLAND, OR 97213-2933
(503) 215-2392
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD156810
OR
208M00000X
Hospitalist Physician
Primary
MD156810
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500647851
—
OR
01
—
P01115313
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
05/19/2009
Last updated
03/22/2021
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