Individual
MR. ANDREW E PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4975 FOOTE RD, STE 400, MEDINA, OH 44256-9048
(330) 591-9038
(330) 722-8585
Mailing address
2000 AUBURN DR, STE 350, BEACHWOOD, OH 44122-4327
(440) 646-1600
(440) 646-1505
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1135037
OH
363A00000X
Physician Assistant
Primary
503004730RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183685
—
OH
Enumeration date
05/01/2016
Last updated
11/03/2025
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