Individual
MARK WILKIN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP
Contact information
Practice address
600 MARY ST, EVANSVILLE, IN 47747
(812) 450-2719
Mailing address
10381 ST ANDREWS CT, EVANSVILLE, ID 47630
(812) 490-4449
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
800279-0971
IN
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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