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Individual

SUSAN ELIZABETH PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6777 ENGLE RD, STE N, MIDDLEBURG HEIGHTS, OH 44130-7941
(440) 627-2040
(770) 237-1627
Mailing address
6777 ENGLE RD, STE N, MIDDLEBURG HEIGHTS, OH 44130-7941
(440) 627-2040
(770) 237-1627

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35081245
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2576798
OH
Enumeration date
05/03/2006
Last updated
10/28/2011
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