Individual
DR. EDWIN PORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Mailing address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 526-2200
(304) 399-1507
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12856
WV
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
12856
WV
207R00000X
Internal Medicine Physician
12856
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0479101
—
OH
05
—
1639376593
—
WV
05
—
64694524
—
KY
01
—
930050958
MEDICARE-RR PROVIDER NUMBER
WV
Enumeration date
07/02/2007
Last updated
04/13/2021
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