Individual
DR. CAROLYN PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10571 TELEGRAPH RD, SUITE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
(804) 261-4935
Mailing address
10571 TELEGRAPH RD, SUITE 110, GLEN ALLEN, VA 23059-4652
(804) 266-9616
(804) 261-4935
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101236627
VA
Other
Enumeration date
07/16/2006
Last updated
07/09/2007
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