Provider Demographics
NPI:1144206558
Name:SHULSINGER, ODED ZION (MD)
Entity Type:Individual
Prefix:DR
First Name:ODED
Middle Name:ZION
Last Name:SHULSINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-0000
Mailing Address - Country:US
Mailing Address - Phone:541-267-5151
Mailing Address - Fax:541-266-4542
Practice Address - Street 1:1900 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-0000
Practice Address - Country:US
Practice Address - Phone:541-267-5151
Practice Address - Fax:541-266-4542
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10657207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR203612Medicaid
OR1407812365OtherNBMC GROUP NPI NUMBER
ORR0000WFBTVOtherMEDICARE GROUP PIN NUMBER
ORCB3544OtherRR MEDICARE GROUP NUMBER
ORP00086145OtherRR MEDICARE PTAN NUMBER
ORP00086145OtherRR MEDICARE PTAN NUMBER
ORC93770Medicare UPIN
OR203612Medicaid
ORR0000WFBTVOtherMEDICARE GROUP PIN NUMBER