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General NPI Number Information
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NPI Number | 1588801898
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Entity Type | Individual
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Provider Name | PAUL S PORTER JR. MD
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Gender | Male
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 07/05/2025
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Provider Practice Location Address
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Address Line | 4494 PALMER RD
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City | BETHESDA
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State | MD
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Zip | 20889-1541
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Country | US
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Telephone | 301-295-4810
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Fax |
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Provider Business Mailing Address
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Address Line | 12170 ABINGTON HALL PL APT 304
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City | RESTON
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State | VA
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Zip | 20190-5850
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Country | US
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Telephone | 973-255-0868
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD13059
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 62553
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | D0091252
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License Number State | MD
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