Individual
MR. JONATHON THOMAS PORTARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
10201 E JEFFERSON AVE, DETROIT, MI 48214-3149
(888) 813-8326
Mailing address
10201 E JEFFERSON AVE, DETROIT, MI 48214
(313) 396-5300
(313) 274-4900
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
4704330807
MI
Other
Enumeration date
12/04/2024
Last updated
02/28/2025
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