Individual
DR. EDWARD S. PORUBSKY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-4400
(706) 721-0112
Mailing address
711 RAVENEL RD, AUGUSTA, GA 30909-1835
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
016410
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
905998
—
SC
Enumeration date
04/17/2006
Last updated
07/09/2007
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