Individual
ROBERT CHARLES PORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
66 MAIN ST, NORTH EASTON, MA 02356-1443
(508) 238-7766
(508) 230-5089
Mailing address
66 MAIN ST, NORTH EASTON, MA 02356-1443
(508) 238-7766
(508) 230-5089
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3248
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0516902
—
MA
01
—
709551
TUFTS HEALTH PLAN
MA
01
—
W03384
BC BS OF MASSACHUSETTS
MA
Enumeration date
06/28/2006
Last updated
07/09/2007
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