Provider Demographics
NPI:1518179613
Name:ANKER, ROBERTO (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:ANKER
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 1:3133 SW VIEW PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-5861
Mailing Address - Country:US
Mailing Address - Phone:503-413-1863
Mailing Address - Fax:503-413-2982
Practice Address - Street 1:2801 N GANTENBEIN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1623
Practice Address - Country:US
Practice Address - Phone:503-268-4802
Practice Address - Fax:503-268-4801
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21761207ZP0102X
WAMD00045473207ZP0102X
MN39612207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR138037Medicaid
931071318OtherTAX ID
ORH11285Medicare UPIN
WAG8879541Medicare PIN
OR220028876Medicare PIN
ORR104154Medicare PIN