Individual
BRENDA ELAINE PORTER
Active
Individual
BRENDA ELAINE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G89267
CA
2084E0001X
Epilepsy Physician
G89267
CA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G89267
CA
2084N0600X
Clinical Neurophysiology Physician
G89267
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8904502
—
NJ
Enumeration date
07/31/2006
Last updated
11/13/2023
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