Individual
ANTHONY JEROME PORTER
Active
Individual
ANTHONY JEROME PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
01058940A
IN
207N00000X
Dermatology Physician
Primary
ME96233
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1358244
AETNA
FL
01
—
246877
WELLCARE
FL
05
—
276029100
—
FL
01
—
55044
BLUE CROSS BLUE SHIELD
FL
01
—
7650363
AETNA
FL
01
—
P00415676
RAILROAD MEDICARE
FL
Enumeration date
06/07/2006
Last updated
09/30/2014
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