Individual
SALVADOR PORTILLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15919 PAISLEY LN, BOWIE, MD 20716-1637
(301) 980-2898
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C08036
MD
Other
Enumeration date
04/06/2021
Last updated
03/26/2024
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