Sally B Portera MD

NPI 1134341746 - Anesthesiology - 207L00000X

NPI Details
NPI 1134341746
Gender Female
Enumeration Date 05/03/2007
Last Updated 03/10/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
211 S 3RD ST
BELLEVILLE IL, 62220-1915, US
Phone (618) 234-2120
Fax (618) 641-5410
Business Location
211 S 3RD ST
BELLEVILLE IL, 62220-1915, US
Phone (618) 234-2120
Fax (618) 641-5410
Toxanomy
Taxonomy Code 207L00000X
License State Missouri
License Number 2009023911
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According to our database, Dr. Sally B Portera MD NPI is 1134341746, taxonomy code is 207L00000X and license number is 2009023911, license state is located at Missouri. Sally B Portera MD physically located at 211 S 3rd St, Belleville IL, 62220-1915. NPI Number Sally B Portera MD has the Individual type.

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1134341746 NPI number is provided on an as is basis without warranty of any kind. 1134341746 is maintained by the National Plan & Provider Enumeration System. The contents of Sally B Portera MD are for informational purposes only.