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NPI Code Detail

MEDICARE: ALBERT ROBERTS PORTER MD

MEDICARE: ALBERT ROBERTS PORTER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMD030734EPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1300057791OTHERPARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508859026
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALBERT ROBERTS PORTER MD
Provider Business Mailing Address
First Line : 4520 UNION DEPOSIT RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17111-2910
Country : US
Telephone Number : 717-652-6105
Fax Number : 717-652-2165
Provider Business Practice Location Address
First Line : 4518 UNION DEPOSIT RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17111-2921
Country : US
Telephone Number : 717-652-5840
Fax Number : 717-652-8152
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 09/11/2013

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Directions to “ ALBERT ROBERTS PORTER MD” Practice Location

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