Individual
RONALD D PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
21431
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706470
MSBCBS GROUP
WV
01
—
001713627
BCBS AAP NUMBER
WV
01
—
001907661
MSBCBS
WV
05
—
0067342000
—
WV
05
—
0207026000
—
WV
01
—
1054827
WORKERS COMP INDIVIDUAL
WV
01
—
205542387
AAP TRI CARE NUMBER
WV
01
—
20554238700
WORKERS COMP
WV
01
—
27005299700
TRICARE
WV
01
—
270052997004
TRICARE
WV
01
—
27005299701
WORKERS COMP
WV
05
—
3810006746
—
WV
01
—
8226335
MEDICARE PTAN
WV
01
—
DA0096
RR MEDICARE
WV
01
—
DF0767
RR MEDICARE
WV
01
—
P00211135
RR MEDICARE
WV
01
—
P00407274
RR MEDICARE
WV
Enumeration date
06/14/2006
Last updated
01/20/2017
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