Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 16747 | NC |
N | 207R00000X | Internist | 16747 | NC |
N | 111NI0900X | Internist | 16747 | NC |
N | 207RH0000X | Hematologist | 16747 | NC |
NPI | 1609995018 |
---|---|
Provider Name | William G Porter |
First Address | Charlotte, NC 28204-2408 |
Second Address | Charlotte, NC 28204-2408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 02/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136UN | BLUE CROSS BLUE SHIELD (01) | NC |
89136UN | (05) | NC |
C86031 | (02) |