Provider Demographics
NPI:1477566974
Name:PAUL M PUZISS MD PC
Entity Type:Organization
Organization Name:PAUL M PUZISS MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:PUZISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-646-8995
Mailing Address - Street 1:3800 SW CEDAR HILLS BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4760
Mailing Address - Country:US
Mailing Address - Phone:503-646-8995
Mailing Address - Fax:503-644-4678
Practice Address - Street 1:3800 SW CEDAR HILLS BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4760
Practice Address - Country:US
Practice Address - Phone:503-646-8995
Practice Address - Fax:503-644-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11897207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR05841ZMedicaid
C93569Medicare UPIN
OR0000BHKSZMedicare ID - Type Unspecified