Individual
ABBIE M. PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
855 A AVE NE STE 105, CEDAR RAPIDS, IA 52402-5060
(319) 368-5992
(319) 369-8251
Mailing address
855 A AVE NE STE 105, CEDAR RAPIDS, IA 52402-5060
(319) 368-5992
(319) 369-8251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174752927
—
IA
01
—
P00831041 CC6519
RR MEDICARE
IA
Enumeration date
07/14/2009
Last updated
03/04/2024
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