Individual
ANDREW JOHN PORTIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 SHERMAN ST, SUITE 400, SAINT PAUL, MN 55102-2564
(651) 999-6800
(651) 999-6810
Mailing address
2550 UNIVERSITY AVE W, SUITE 240N, SAINT PAUL, MN 55114-1052
(651) 999-6909
(651) 297-6115
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
42720
MN
Other
Enumeration date
10/04/2005
Last updated
07/08/2007
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