Individual
DR. MARVIN M PORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1783 SHELL RING CIR, MOUNT PLEASANT, SC 29466-8030
(310) 266-3050
(310) 454-5318
Mailing address
1783 SHELL RING CIR, MOUNT PLEASANT, SC 29466-8030
(310) 266-3050
(310) 454-5318
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
C28757
CA
207KA0200X
Allergy Physician
Primary
MD87328
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD87328
STATE OF SOUTH CAROLINA
SC
Enumeration date
07/13/2006
Last updated
04/18/2022
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