Individual
DR. DIEGO PORRAS INGOUVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
241562
MA
2080P0202X
Pediatric Cardiology Physician
241562
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620476822
TAX ID
—
Enumeration date
06/26/2006
Last updated
10/06/2020
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