Individual
DR. MICHAEL PORUBCIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Mailing address
600 JOHN DEERE ROAD, SUITE 200, MOLINE, IL 61265-6897
(309) 779-4200
(309) 779-4305
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036100264
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100264
—
IL
01
—
130020688
RR MEDICARE
IL
Enumeration date
01/25/2006
Last updated
10/12/2021
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