Individual
MR. NIRMAL BASTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5900 INLAND SHORES WAY N, KEIZER, OR 97303-3883
(503) 399-2424
(503) 589-6240
Mailing address
2020 CAPITOL ST NE, SALEM, OR 97301-0644
(503) 399-2424
(503) 375-7429
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6135
NE
207Q00000X
Family Medicine Physician
Primary
MD181082
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500721109
—
OR
Enumeration date
08/06/2009
Last updated
06/07/2017
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