Individual
CEDRIC ELMER PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
124 VICTORY DRIVE, SWAINSBORO, GA 30401
(478) 237-5506
(478) 237-5508
Mailing address
124 VICTORY DR, SWAINSBORO, GA 30401-3235
(478) 237-5506
(478) 237-5508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
029363
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000347311B
—
GA
Enumeration date
05/24/2006
Last updated
05/17/2010
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