Individual
FREDERICK PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1655 N GLADSTONE AVE, STE E, COLUMBUS, IN 47201-5392
(812) 376-3071
(812) 378-5721
Mailing address
1655 N GLADSTONE AVE, STE E, COLUMBUS, IN 47201-5392
(812) 376-3071
(812) 378-5721
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01022304A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100336290
—
IN
Enumeration date
07/01/2005
Last updated
02/09/2010
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