| Dawn M. Porter, Md | |
|
1004 Pebble Beach Dr Caseyville IL 62232-2834 | |
| (913) 461-0369 | |
| (913) 461-0832 |
| Full Name | Dawn M. Porter, Md |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 1004 Pebble Beach Dr, Caseyville, Illinois |
| Authorized Official Name and Position | Dawn Michelle Porter (FOUNDER/CEO) |
| Authorized Official Contact | 9134610369 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dawn M. Porter, Md 1004 Pebble Beach Dr Caseyville IL 62232-2834 Ph: (913) 461-0369 | Dawn M. Porter, Md 1004 Pebble Beach Dr Caseyville IL 62232-2834 Ph: (913) 461-0369 |
| NPI Number | 1225404551 |
|---|---|
| Provider Enumeration Date | 08/21/2015 |
| Last Update Date | 08/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225404551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 113680 (Missouri) | Primary |
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