PAUL E. VANBREDAVRIESMAN M.D. – NPI #1043453582
Family Medicine

The NUCC recommends this code not be used. Choose a more appropriate code.

PAUL VANBREDAVRIESMAN is a physician located in GRESHAM, OR. NPPES has assigned the NPI number 1043453582 to PAUL VANBREDAVRIESMAN on April 14, 2009. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207QA0505X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adult Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PAUL VANBREDAVRIESMAN below.

NPI Profile for
PAUL E. VANBREDAVRIESMAN

NPI Number
1043453582
Enumeration Date

(more than 17 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
PAUL E. VANBREDAVRIESMAN
Credentials
M.D.
Primary location
18000 SE STARK STREET
GRESHAM, OR 97233
Phone: (503) 255-4243 Fax: (503) 255-4243
Mailing address
16244 NE SAN RAFAEL DR
18000 SE STARK STREET
PORTLAND, OR 97230-5661
Phone: (503) 255-4243 Fax: (503) 255-4243
Sole Proprietor
No
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0505X
- Family Medicine / Adult Medicine (Primary)
OR MD11073

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.