Provider Demographics
NPI:1821088410
Name:PORTERA, JOSEPH CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHRISTOPHER
Last Name:PORTERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 GLENWOOD DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1108
Mailing Address - Country:US
Mailing Address - Phone:423-495-3304
Mailing Address - Fax:423-495-2589
Practice Address - Street 1:605 GLENWOOD DR
Practice Address - Street 2:SUITE 105
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1108
Practice Address - Country:US
Practice Address - Phone:423-495-3304
Practice Address - Fax:423-495-2589
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000025662207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3060933OtherBLUECROSS BLUESHIELD/TN
TN3060933OtherBLUECARE
TN3060933OtherBLUECARD
TN3060933OtherBLUECARE
G22087Medicare UPIN