Individual
DR. BRIAN OSCAR PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12413 JAMES MADISON LN, GLENN DALE, MD 20769-9168
(804) 243-2136
Mailing address
12413 JAMES MADISON LN, GLENN DALE, MD 20769-9168
(804) 243-2136
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101237244
VA
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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