Provider Demographics
NPI:1255334926
Name:REGAN, DAVID HAROLD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HAROLD
Last Name:REGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5050 NE HOYT ST
Mailing Address - Street 2:STE 256
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2982
Mailing Address - Country:US
Mailing Address - Phone:503-239-7767
Mailing Address - Fax:503-215-6897
Practice Address - Street 1:5050 NE HOYT ST
Practice Address - Street 2:STE 256
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2982
Practice Address - Country:US
Practice Address - Phone:503-239-7767
Practice Address - Fax:503-215-6897
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2013-02-19
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Provider Licenses
StateLicense IDTaxonomies
ORMD08498207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1006005Medicaid
OR164871Medicaid
OR164871Medicaid
ORC91564Medicare UPIN
OR105529Medicare PIN