Individual
DAVID A PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10767 ILLINOIS ST STE 3000, CARMEL, IN 46032-8972
(317) 817-1200
(317) 817-1220
Mailing address
10767 ILLINOIS ST STE 3000, CARMEL, IN 46032-8972
(317) 817-1200
(317) 817-1220
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01038677A
IN
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
01038677A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
1038677A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200034164
RR MEDICARE
IN
05
—
200161470A
—
IN
Enumeration date
05/26/2006
Last updated
05/11/2023
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