Provider Demographics
NPI:1700067360
Name:LAMICHHANE, DIMAN RAJ (MD)
Entity Type:Individual
Prefix:DR
First Name:DIMAN
Middle Name:RAJ
Last Name:LAMICHHANE
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 1:633 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3602
Mailing Address - Country:US
Mailing Address - Phone:541-434-5585
Mailing Address - Fax:541-345-2821
Practice Address - Street 1:633 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3602
Practice Address - Country:US
Practice Address - Phone:541-434-5585
Practice Address - Fax:541-345-2821
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP22253207R00000X
ND11584207R00000X
DCMD042094207RR0500X
ORMD176833207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR188893Medicare UPIN