Individual
ROBERT PORTER II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1346 E CANDLERIDGE DR, BOISE, ID 83712-6504
(208) 426-0491
Mailing address
1346 E CANDLERIDGE DR, BOISE, ID 83712-6504
(208) 426-0491
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-3299
ID
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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