Provider Demographics
NPI:1932147600
Name:INTERNAL MEDICINE CONSULTANTS PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:NIRAJ
Authorized Official - Last Name:BINDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-320-2121
Mailing Address - Street 1:6107 SW MURRAY BLVD
Mailing Address - Street 2:# 516
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-4421
Mailing Address - Country:US
Mailing Address - Phone:503-320-2121
Mailing Address - Fax:503-641-4158
Practice Address - Street 1:14355 SW ALLEN BLVD
Practice Address - Street 2:130
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4700
Practice Address - Country:US
Practice Address - Phone:503-320-2121
Practice Address - Fax:503-641-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23239207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORH53457Medicare UPIN