Individual
DR. SAMUEL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7234
Mailing address
975 E 3RD ST # 376, CHATTANOOGA, TN 37403-2147
(423) 778-7234
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
51053
TN
2085R0202X
Diagnostic Radiology Physician
Primary
51053
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q006866
—
TN
Enumeration date
08/18/2008
Last updated
10/04/2018
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