Most Relevant Information
Provider Data
| NPI Number: | 1003694977 |
| Provider Name: | CARLY MICHELE PORTER PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | C5-0011970 |
Most Important Dates
| Enumeration Date: | 09/20/2023 |
| Last Updated: | 09/20/2023 |
Provider Practice Location
4755 OGLETOWN STANTON RD
NEWARK
DE
197182200
Practice Location Phone/Fax
| Phone: | 3027336900 |
| Fax: |
Provider Mailing Location
55 ALEXIS DR
NEWARK
DE
197025494
Provider Mailing Phone/Fax
| Phone: | 5403200749 |
| Fax: |