Provider Demographics
NPI:1275518730
Name:PORTER, SATOKO H (MD RCEP CDE)
Entity Type:Individual
Prefix:MS
First Name:SATOKO
Middle Name:H
Last Name:PORTER
Suffix:
Gender:F
Credentials:MD RCEP CDE
Other - Prefix:
Other - First Name:SATOKO
Other - Middle Name:
Other - Last Name:HAYAKAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:75 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-9147
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:781-878-3989
Practice Address - Street 1:75 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-9147
Practice Address - Country:US
Practice Address - Phone:781-878-5200
Practice Address - Fax:781-878-3989
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24622083S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine