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Individual
MR. MESIAH O'MAR PORTER JR.
Active
Individual
MR. MESIAH O'MAR PORTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
83-1469962
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018003411
AMERICAN NURSES CREDENTIALING CENTER
GA
01
—
RN242562
GEORGIA PROFESSIONAL LICENSING
GA
Enumeration date
04/23/2019
Last updated
04/23/2019
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