Individual
DR. ALSTON MICHAEL PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11115 PARKVIEW PLAZA DR, DEPT. OF NEONATOLOGY, FORT WAYNE, IN 46845-1701
(260) 672-6400
(260) 672-6459
Mailing address
1234 E DUPONT RD, SUITE 1, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
G7566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641379
ANTHEM
IN
Enumeration date
05/14/2006
Last updated
03/23/2013
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