Theodore B Porter, DO | |
1413 W Moyamensing Ave, 1st Floor, Philadelphia, PA 19145-4625 | |
(267) 639-2555 | |
(267) 639-2632 |
Full Name | Theodore B Porter |
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Gender | Male |
Speciality | Family Medicine |
Location | 1413 W Moyamensing Ave, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689672479 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OS003735L (Pennsylvania) | Primary |
Entity Name | Theodore B Porter Do Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851735302 PECOS PAC ID: 9830336494 Enrollment ID: O20130520000266 |
Mailing Address | Practice Location Address |
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Theodore B Porter, DO 1413 W Moyamensing Ave, 1st Floor, Philadelphia, PA 19145-4625 Ph: (267) 639-2555 | Theodore B Porter, DO 1413 W Moyamensing Ave, 1st Floor, Philadelphia, PA 19145-4625 Ph: (267) 639-2555 |
Srikar Vegesna, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2118 Cottman Ave, Philadelphia, PA 19149 Phone: 215-342-3020 Fax: 215-342-3653 | |
Chelsea Tiffany Salas-tam, Family Medicine Medicare: Medicare Enrolled Practice Location: 861 E Allegheny Ave, Philadelphia, PA 19134 Phone: 215-302-3600 | |
Kunal Anandpara, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 11000 Roosevelt Blvd, Philadelphia, PA 19116 Phone: 215-677-1475 Fax: 215-677-3082 | |
Joshua George, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 133 W Hunting Park Ave, Philadelphia, PA 19140 Phone: 215-324-0600 Fax: 215-324-2795 | |
Meng-chao Lee, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7500 Central Ave Ste 104, Philadelphia, PA 19111 Phone: 215-742-0712 Fax: 215-742-5218 | |
Carol Bowes-lawlor, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 33 E Chestnut Hill Ave, Philadelphia, PA 19118 Phone: 215-753-9080 Fax: 215-753-8830 | |
Dr. Seung Hee Hong, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2301 E Allegheny Ave, Suite 150, Philadelphia, PA 19134 Phone: 215-926-3535 Fax: 215-926-3536 |