Individual
CHARLES EDMOND PORTERFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3771 ROBERT C BYRD DRIVE, BECKLEY, WV 25801
(304) 255-5710
(304) 255-5702
Mailing address
PO BOX 1307, BECKLEY, WV 25802-1307
(304) 255-5710
(304) 255-5702
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
1084
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706070
BCBS
WV
05
—
0070983001
—
WV
01
—
155429
UMWA FUNDS
—
01
—
256325
FEDERAL DOL
—
01
—
4245814
AETNA
WV
Enumeration date
04/13/2006
Last updated
03/26/2014
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