Provider Demographics
NPI:1194934307
Name:UMBERHANDT, ROBERT CECIL (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CECIL
Last Name:UMBERHANDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 N GRAHAM ST
Mailing Address - Street 2:LEGACY BONE AND JOINT CLINIC SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1654
Mailing Address - Country:US
Mailing Address - Phone:503-413-4488
Mailing Address - Fax:503-413-1812
Practice Address - Street 1:501 N GRAHAM ST
Practice Address - Street 2:LEGACY BONE AND JOINT CLINIC SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1654
Practice Address - Country:US
Practice Address - Phone:503-413-4488
Practice Address - Fax:503-413-1812
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD159896207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery