DR. OMAR N QUTUB


Address: 1129 Nw 11th Ave, Portland, OR 97209-3469
Phone: 5037052331

DR. OMAR N QUTUB (NPI# 1124280540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124280540
Entity Type Individual
Full Name DR. OMAR N QUTUB
Credential MD
Practice Address 1129 Nw 11th Ave
Portland
OR 97209-3469
Practice Telephone 5037052331
Mailing Telephone 5037052331
Enumeration Date 2008-06-26
Last Update Date 2018-02-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology MD158125 OR Allopathic & Osteopathic Physicians

Office Location

Street Address 1129 NW 11TH AVE
City PORTLAND
State OR
Zip Code 97209-3469

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972004455 Dermatology By Design LLC Dermatology 1129 Nw 11th Ave, Portland, OR 97209-3469 2018-02-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508476250 Harrington Health Clinic Nurse Practitioner 310 Nw Glisan Street, Portland, OR 97209 2020-08-07
1619599636 Rivers Way Training Clinic Community/Behavioral Health 2049 Nw Hoyt, Portland, OR 97209 2020-05-13
1518590538 Julie Kay Igarta Registered Nurse 140 Northwest 14th Avenue, Portland, OR 97209 2020-02-18
1407492002 Oregon Injection Clinic Clinic/Center 1500 Nw Lovejoy, 106, Portland, OR 97209 2019-11-19
1487202883 Ann Tesora Massage Therapist 1320 Northwest 20th Avenue, Portland, OR 97209 2019-08-28
1972160455 Vincent Martin Massage Therapist 210 Sw 17th Avenue, Portland, OR 97209 2019-05-21
1154896546 Jennifer Marie Dodd Social Worker 1722 Nw Raleigh St Spc 412, Portland, OR 97209 2018-10-11
1922551910 Ashley Crowell Physician Assistant 949 Nw Overton St Unit 306, Portland, OR 97209 2016-07-26
1326408394 Jennifer Blain Counselor 324 Nw Davis, Portland, OR 97209 2016-03-03
1275993255 Lauren Dodson Licensed Practical Nurse 324 Nw Davis St, Portland, OR 97209 2016-03-03
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508303561 Carter Kroeplin Haag Dermatology 3303 S Bond Ave # 16d, Portland, OR 97239-4501 2017-01-27
1043765134 Noelle Teske Dermatology 3303 S Bond Ave Fl 16, Portland, OR 97239-4501 2016-08-18
1134579535 Caroline Morris Dermatology 3303 S Bond Ave # Chh16d, Portland, OR 97239-4501 2016-06-16
1033539184 Natasha Fewkes Carter Dermatology 4914 Sw 1st Ave, Portland, OR 97239-2883 2014-04-16
1538588504 Elizabeth Berry Dermatology Ohsu Department of Dermatology, 3303 Sw Bond Ave Ch 16d, Portland, OR 97239-4501 2014-04-07
1124250584 Einar Axel Juhlin Dermatology 340 Eastern Promenade, Unit 154, Portland, ME 04101-2754 2009-08-19
1902040777 Rajan P Kulkarni Dermatology 3303 Sw Bond Ave Ste 16, Portland, OR 97239 2009-04-23
1285891168 Stacy Nicole Reed Dermatology 13305 Nw Cornell Rd Ste C, Portland, OR 97229-5987 2008-05-19
1427243591 Robert Bickford Amon Dermatology 1700 Sw Broadway Dr, Portland, OR 97201-2211 2007-09-11
1528250727 Sabra Lofgren Leitenberger Dermatology 3303 Sw Bond Avenue Ch 16d, Ohsu Dermatology, Portland, OR 97239 2007-08-13
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Competitor

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City PORTLAND
Zip Code 97209

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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