Individual
DR. BRANDON ROBERT PORTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2601 CENTENNIAL DR, STE 100, NORTH SAINT PAUL, MN 55109-3087
(651) 777-7414
(651) 748-5839
Mailing address
2025 SLOAN PL, STE 35, SAINT PAUL, MN 55117-2092
(651) 227-6551
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
66104
MN
Other
Enumeration date
05/07/2018
Last updated
07/19/2021
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