Poortenga, Cynthia L
Poortenga, Cynthia L is an sole proprietor health care provider with primary practice located at 121 E Ravine Rd Ste 900, Kingsport TN 37660-3800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Poortenga, Cynthia L can be contacted via phone (423) 230-4800.Contact Information
Primary practice address
121 E Ravine Rd Ste 900
Kingsport TN 37660-3800
Phone: (423) 230-4800
Fax: (423) 230-4808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD0000017131 | Tennessee |
Profile Details
| NPI number | 1811991631 |
|---|---|
| LBN Legal business name | Poortenga, Cynthia L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2005 |
| Last updated | Feb 27th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811991631 | NPPES |
| Virginia | Other | 5645956 | VA MEDICAID |
| Virginia | MEDICAID | 3372564 | VA MEDICAID |
| Virginia | Other | 246269 | VA MEDICAID |
| Virginia | Other | 4054392 | VA MEDICAID |
| Virginia | Other | 830342546-01 | VA MEDICAID |
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