Individual
DAVID H PORTER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5550 S EAST ST, STE.I, INDIANAPOLIS, IN 46227-1979
(317) 780-4080
(317) 780-4088
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01023971A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100176970
—
IN
Enumeration date
05/26/2006
Last updated
06/30/2016
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