Individual
ROBERT S PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
0101280265
VA
2085R0202X
Diagnostic Radiology Physician
134786-1
NY
2085R0202X
Diagnostic Radiology Physician
G88069
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G880690
—
CA
Enumeration date
09/21/2006
Last updated
10/09/2024
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