Individual
JOSHUA PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 FAIRWAY DR, ALTOONA, PA 16602
(814) 942-1166
(814) 942-6222
Mailing address
3000 FAIRWAY DR, ALTOONA, PA 16602-4472
(814) 942-1166
(814) 942-6222
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD042447L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014632950003
—
PA
Enumeration date
03/14/2006
Last updated
10/01/2015
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