Individual
SALVADOR C. PORTUGAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 DIVISION ST, SUITE 9, SOUTH CHARLESTON, WV 25309-1459
(304) 766-3482
Mailing address
PO BOX 9288, SOUTH CHARLESTON, WV 25309-0288
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
13580
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101112000
—
WV
Enumeration date
05/02/2006
Last updated
11/27/2013
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