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General NPI Number Information
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NPI Number | 1225558737
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Entity Type | Individual
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Provider Name | ANDREW PORTER MD
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Gender | Male
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 100 ONEIL BLVD
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City | ATTLEBORO
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State | MA
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Zip | 02703-4250
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Country | US
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Telephone | 508-342-1103
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Fax | 508-342-1945
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Provider Business Mailing Address
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Address Line | 100 ONEIL BLVD
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City | ATTLEBORO
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State | MA
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Zip | 02703-4250
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Country | US
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Telephone | 508-342-1103
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Fax | 508-342-1945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MT213898
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1014210
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License Number State | MA
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