Paul T Porter, M.D.

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

PP049599 Issued in MI

Practice address

19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857

Phone

(313) 884-5522

Fax

(313) 884-5521

NPI assigned

Jul 28, 2006

Last updated

Feb 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1588678155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857",
            "telephone_number": "313-884-5522",
            "fax_number": "313-884-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857",
            "telephone_number": "313-884-5522",
            "fax_number": "313-884-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PAUL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "PP049599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "0829220",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4207000",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4207010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pointe Vision Care PC
• Laila Amyre Ponder
• Alicia Joan Porter, OTR/L
• Jasmin D Porter
• Kayde Porter
• Asia Siera Pratt
• Stephanie J Price, P.T., D.P.T.
• Sharquise Jalisa Prince
• Chelsea Prush
• Indya Diane Purry

• Medical Oncology Physician in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Medical Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.