Provider Demographics
NPI:1073807129
Name:THURMOND, PORTIA ELISE (MD)
Entity Type:Individual
Prefix:MISS
First Name:PORTIA
Middle Name:ELISE
Last Name:THURMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TIMBERWOOD DR
Mailing Address - Street 2:UNIT 303
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-4416
Mailing Address - Country:US
Mailing Address - Phone:401-301-0834
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC DEPARTMENT OF GENERAL SURGERY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program