Portera, Stephen Gregory

Portera, Stephen Gregory is an individual health care provider with primary practice located at 6215 Humphreys Blvd Ste 110 , Memphis TN 38120-2382. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Portera, Stephen Gregory can be contacted via phone (901) 227-9610.

Contact Information

Primary practice address
6215 Humphreys Blvd Ste 110 Memphis TN 38120-2382
Phone: (901) 227-9610
Fax: (901) 227-9615
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD25742 Tennessee
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 25742 Tennessee

Profile Details

NPI number 1205803608
LBN Legal business name Portera, Stephen Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2006
Last updated Mar 30th, 2023 - about last year

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 1205803608 NPPES
Tennessee MEDICAID 3800896
Tennessee Other 4015978
Tennessee MEDICAID 07659397
Tennessee MEDICAID 04123847
Tennessee Other 97375

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