Individual
DR. LAURIE CORDARO D'AVIGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD156715
OR
207RI0200X
Infectious Disease Physician
01055283A
IN
207RI0200X
Infectious Disease Physician
Primary
MD156715
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500648662
—
OR
01
—
P01085387
MEDICARE RAILROAD
OR
Enumeration date
02/17/2006
Last updated
09/12/2013
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