Provider Demographics
NPI:1992765036
Name:PORWAY, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:PORWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:22 ATWOOD DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-4272
Mailing Address - Country:US
Mailing Address - Phone:413-570-4900
Mailing Address - Fax:413-570-4196
Practice Address - Street 1:22 ATWOOD DR
Practice Address - Street 2:SUITE 301
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4272
Practice Address - Country:US
Practice Address - Phone:413-570-4900
Practice Address - Fax:413-570-4196
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA58063207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA04-3476949OtherUNICARE/GIC
MA04-3476949OtherCONSOLIDATED
MA04-3476949OtherNORTH AMERICAN PREFERRED
MA04-3476949OtherNORTHEAST HEALTH DIRECT
MA04-3476949OtherPLAN VISTA
MA110044797AMedicaid
MA04-3476949OtherHEALTH NEW ENGLAND
MAJ06661OtherBCBSMA
MA04-3476949OtherNORTHEAST HEALTHCARE ALLI
MA15514OtherHEALTH NEW ENGLAND
MA3025365Medicaid
MA04-3476949OtherPHCS
MA058063OtherTUFTS
MA04-3476949OtherNORTH AMERICAN PREFERRED
B98052Medicare UPIN
MA04-3476949OtherNORTHEAST HEALTH DIRECT
MA1095714OtherAETNA
MA3025365Medicaid