Individual
DR. EDWIN D PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DM, DC
Contact information
Practice address
4531 EVERHARD RD NW, CANTON, OH 44718-2406
(330) 499-0642
(330) 499-2257
Mailing address
1247 MAXFLI DR, AKRON, OH 44312-5930
(330) 936-4111
(330) 499-2257
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
316
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000164597
ANTHEM BC/BS
OH
05
—
009880-8
—
OH
01
—
341258286027
CARESOURCE
OH
01
—
P00247842
RAILROAD MEDICARE
OH
Enumeration date
06/28/2006
Last updated
07/08/2007
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