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Individual

MRS. LULA G. PORTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4666 RADNOR ROAD, INDIANAPOLIS, IN 46226-2154
(317) 547-7669
(317) 240-4357
Mailing address
4666 RADNOR ROAD, INDIANAPOLIS, IN 46226-2154
(317) 547-7669
(317) 240-4357

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
01019700A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20032340
IN
Enumeration date
09/30/2006
Last updated
09/22/2015
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