Provider Demographics
NPI:1659423291
Name:CONANT-NORVILLE, DAVID OLIVER (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:OLIVER
Last Name:CONANT-NORVILLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:18650 NW CORNELL RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9207
Mailing Address - Country:US
Mailing Address - Phone:503-352-0468
Mailing Address - Fax:503-352-1024
Practice Address - Street 1:18650 NW CORNELL RD
Practice Address - Street 2:SUITE 315
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9207
Practice Address - Country:US
Practice Address - Phone:503-352-0468
Practice Address - Fax:503-352-1024
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR136432084P0804X, 2084S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine