Individual
DR. PAUL WILLIAM PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01078465A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004192
—
IN
Enumeration date
04/23/2012
Last updated
11/02/2017
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