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Individual

DR. PAUL S PORTER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4494 PALMER RD, BETHESDA, MD 20889-1541
(301) 295-4810
Mailing address
12170 ABINGTON HALL PL APT 304, RESTON, VA 20190-5850
(973) 255-0868

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
62553
CT
207P00000X
Emergency Medicine Physician
Primary
D0091252
MD
207P00000X
Emergency Medicine Physician
MD13059
RI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001261801
MEDICARE
RI
01
07/14/2009
UNITED HEALTH CARE
RI
01
10/08/2009
NHPRI
RI
01
10/27/2009
TUFTS HEALTH PLAN
MA
01
10/27/2009
BCBS
RI
01
1962455022
UEMF GROUP NPI
RI
01
939025129
MEDICARE GROUP NUMBER
RI
05
PP76984
RI
Enumeration date
01/09/2009
Last updated
07/05/2025
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