Healthcare Provider Details

I. General information

NPI: 1275518730
Provider Name (Legal Business Name): SATOKO H PORTER MD RCEP CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SATOKO HAYAKAWA

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 WASHINGTON STREET
NORWELL MA
02061-9147
US

IV. Provider business mailing address

75 WASHINGTON STREET
NORWELL MA
02061-9147
US

V. Phone/Fax

Practice location:
  • Phone: 781-878-5200
  • Fax: 781-878-3989
Mailing address:
  • Phone: 781-878-5200
  • Fax: 781-878-3989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083S0010X
TaxonomySports Medicine (Preventive Medicine) Physician
License Number2462
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: