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Individual

MICHAEL E PORTNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
803 FIRST STREET, CLEVELAND, MS 38732
(662) 843-2721
Mailing address
PO BOX 306, DELTA HILLS NEPHROLOGY ASSOCIATES, GREENWOOD, MS 38935-0306
(662) 453-5208
(662) 453-4546

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
09174
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00115736
MS
Enumeration date
12/04/2006
Last updated
07/08/2007
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