Individual
JEFFREY PORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1019 S BROAD ST, LANSDALE, PA 19446-5338
(215) 361-5090
(215) 412-4296
Mailing address
1019 S BROAD ST, LANSDALE, PA 19446-5338
(215) 361-5090
(215) 412-4296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD044627E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017079620004
—
PA
Enumeration date
04/08/2006
Last updated
04/19/2012
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