Individual
EDWARD A PORUBSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
340 N BELAIR RD, EVANS, GA 30809-3000
(706) 868-5676
(706) 722-2824
Mailing address
340 N BELAIR RD, EVANS, GA 30809-3000
(706) 868-5676
(706) 722-2824
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
053019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157315300
EMPLOYMENT STANDARD WORK
—
01
—
3285145
CIGNA
—
01
—
4305494
AETNA
—
05
—
519526707A
—
GA
01
—
952703
BLUE CROSS
GA
01
—
P00177360
MEDICARE RAILROAD
GA
Enumeration date
02/27/2006
Last updated
01/06/2010
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