Individual
GLYN ANNE PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2901 PEPPER CREEK BRIDGE PKWY, VALPARAISO, IN 46385-7127
(219) 405-9950
(219) 464-3873
Mailing address
2901 PEPPER CREEK BRIDGE PKWY, VALPARAISO, IN 46385-7127
(219) 405-9950
(219) 464-3873
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01044317A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200409510
—
IN
Enumeration date
09/19/2005
Last updated
12/12/2011
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