Individual
PETER JOHN PORCELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
39465
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47359
MEDCOST
—
01
—
5473696
AETNA
—
05
—
6717934
—
VA
01
—
6805
PARTNERS
—
01
—
68446
BCBS
—
05
—
8968446
—
NC
Enumeration date
01/19/2006
Last updated
12/28/2011
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