Individual
DR. RICHARD B PORWANCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1245 WHITEHORSE MERCERVILLE RD, SUITE 411, MERCERVILLE, NJ 08619-3831
(609) 581-2000
(609) 581-5450
Mailing address
1245 WHITEHORSE MERCERVILLE RD, SUITE 411, MERCERVILLE, NJ 08619-3831
(609) 581-2000
(609) 581-5450
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MA40394
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0148186000
KEYSTONE
—
01
—
142409
AMERIHEALTH
—
01
—
223381766
TAX ID
—
01
—
33891
AETNA ID
—
05
—
3708306
—
NJ
01
—
4096880
AETNA
—
01
—
440002476
RAILROAD MEDICARE
NJ
01
—
MEP089
OXFORD #
—
Enumeration date
08/01/2006
Last updated
05/15/2008
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