Porter, Craig C

Porter, Craig C is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Nephrology, Milwaukee WI 53226-4874. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as his primary health care specialty. Porter, Craig C can be contacted via phone (414) 337-7702.

Contact Information

Primary practice address
9000 W Wisconsin Ave Pediatric Nephrology Milwaukee WI 53226-4874
Phone: (414) 337-7702
Fax: (414) 337-7105
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X 27617 Iowa
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X 51603 Wisconsin

Profile Details

NPI number 1265413298
LBN Legal business name Porter, Craig C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Sep 15th, 2011 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265413298 NPPES
Iowa Other 29989 WELLMARK BCBS
Iowa MEDICAID 0299891 WELLMARK BCBS
Iowa MEDICAID 1265413298 WELLMARK BCBS

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