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Individual

DR. ANGELA M PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
46156 WOODWARD AVE, SUITE B, PONTIAC, MI 48342-5033
(248) 322-6747
(248) 322-3071
Mailing address
6820 OYSTER CV, WEST BLOOMFIELD, MI 48323-2051
(313) 333-0620
(248) 322-3071

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
AP064427
MI
208D00000X
General Practice Physician
Primary
4301064427
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4483390
MI
Enumeration date
07/08/2005
Last updated
02/08/2017
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