Basic Information
| Provider Information | |||||||||
| NPI: | 1982044954 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PORTER | ||||||||
| FirstName: | NOAH | ||||||||
| MiddleName: | EDWARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2725 S 144TH ST STE 212 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681445253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026370800 | ||||||||
| FaxNumber: | 4026370808 | ||||||||
| Practice Location | |||||||||
| Address1: | 2725 S 144TH ST STE 212 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681445253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026370800 | ||||||||
| FaxNumber: | 4026370808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2013 | ||||||||
| LastUpdateDate: | 06/24/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD-46540 | IA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD464144 | PA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0117X | 31850 | NE | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | 207X00000X | 31850 | NE | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0117X | MD-46540 | IA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
No ID Information.