Provider Demographics
NPI:1285920579
Name:PORTER, FORBES DENNISON (MD)
Entity type:Individual
Prefix:DR
First Name:FORBES
Middle Name:DENNISON
Last Name:PORTER
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 1:10 CENTER DR
Mailing Address - Street 2:10-CRC, ROOM 5-2571
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892
Mailing Address - Country:US
Mailing Address - Phone:301-435-4432
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:10-CRC, ROOM 5-2571
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892
Practice Address - Country:US
Practice Address - Phone:301-435-4432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045118207SG0201X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics