Provider Demographics
NPI:1942256029
Name:NANCY CUROSH, MD, PC
Entity Type:Organization
Organization Name:NANCY CUROSH, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CUROSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-238-2941
Mailing Address - Street 1:PO BOX 23200
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97281-3200
Mailing Address - Country:US
Mailing Address - Phone:503-670-6322
Mailing Address - Fax:503-968-2779
Practice Address - Street 1:5050 NE HOYT ST
Practice Address - Street 2:SUITE 234
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2991
Practice Address - Country:US
Practice Address - Phone:503-238-2941
Practice Address - Fax:503-239-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17144207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR460002008OtherRAILROAD MEDICARE
OR028097Medicaid
OR028097Medicaid
ORE34923Medicare UPIN