Provider Demographics
NPI:1356640338
Name:JOSEPH PORRES MD PC
Entity type:Organization
Organization Name:JOSEPH PORRES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-762-7364
Mailing Address - Street 1:50 W EDMONSTON DR
Mailing Address - Street 2:308
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1228
Mailing Address - Country:US
Mailing Address - Phone:307-762-7364
Mailing Address - Fax:
Practice Address - Street 1:50 W EDMONSTON DR
Practice Address - Street 2:308
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1228
Practice Address - Country:US
Practice Address - Phone:307-762-7364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0044137207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty