Provider Demographics
NPI:1508849084
Name:PORTWOOD, MARGARET M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:M
Last Name:PORTWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PEGGY
Other - Middle Name:
Other - Last Name:PORTWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2825 J ST
Mailing Address - Street 2:STE. 435
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4300
Mailing Address - Country:US
Mailing Address - Phone:916-440-8005
Mailing Address - Fax:916-440-1030
Practice Address - Street 1:2825 J ST
Practice Address - Street 2:STE. 435
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4300
Practice Address - Country:US
Practice Address - Phone:916-440-8005
Practice Address - Fax:916-440-1030
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG387582081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47583Medicare UPIN