Provider Demographics
NPI:1336264373
Name:SCHIRRIPA, OSVALDO A (MD)
Entity Type:Individual
Prefix:DR
First Name:OSVALDO
Middle Name:A
Last Name:SCHIRRIPA
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 1:143 SW SHEVLIN HIXON DR
Mailing Address - Street 2:SUITE #203
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3189
Mailing Address - Country:US
Mailing Address - Phone:541-633-7172
Mailing Address - Fax:
Practice Address - Street 1:143 SW SHEVLIN HIXON DR
Practice Address - Street 2:SUITE #203
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3189
Practice Address - Country:US
Practice Address - Phone:541-633-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46201207ZP0101X
ORMD153157207SG0201X, 207SG0203X
CO39144207SG0201X, 207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF84087Medicare UPIN