Provider Demographics
NPI:1396917332
Name:PORTERA, CHIA C (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CHIA
Middle Name:C
Last Name:PORTERA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:CHIA
Other - Middle Name:
Other - Last Name:CHIAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BUILDING 10 RM12N226
Mailing Address - Street 2:10 CENTER DR.
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-496-3986
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 10 RM12N226
Practice Address - Street 2:10 CENTER DR.
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063372284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital