Provider Demographics
NPI:1831141910
Name:MARKOWITZ, NATHAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:R
Last Name:MARKOWITZ
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 1:10 COBURG RD. #201
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-726-4686
Mailing Address - Fax:541-726-5056
Practice Address - Street 1:10 COBURG RD. #201
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-726-4686
Practice Address - Fax:541-726-5056
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14889207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR138933Medicaid
ORC91813Medicare UPIN
OR0000WCJWGEMedicare PIN