Provider Demographics
NPI:1093030074
Name:ROTRAMEL, ALIZAH RABIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIZAH
Middle Name:RABIN
Last Name:ROTRAMEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1040 NW 22ND AVE.
Mailing Address - Street 2:SUITE 540
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210
Mailing Address - Country:US
Mailing Address - Phone:503-413-5525
Mailing Address - Fax:503-413-5526
Practice Address - Street 1:1040 NW 22ND AVE
Practice Address - Street 2:SUITE 540
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3057
Practice Address - Country:US
Practice Address - Phone:503-413-5525
Practice Address - Fax:503-413-5526
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD159735208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery