Individual
LAUREN O PORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3999 RICHMOND RD, BEACHWOOD, OH 44122-6046
(216) 844-3836
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34006531
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0355477
—
OH
Enumeration date
06/30/2006
Last updated
07/15/2011
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