Individual
STEPHEN GREGORY PORTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6215 HUMPHREYS BLVD STE 110, MEMPHIS, TN 38120-2382
(901) 227-9610
(901) 227-9615
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
25742
TN
208800000X
Urology Physician
Primary
MD25742
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04123847
—
MS
05
—
07659397
—
MS
05
—
3800896
—
TN
01
—
4015978
BCBST
TN
01
—
97375
BCBS AR
AR
Enumeration date
03/03/2006
Last updated
03/30/2023
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