Provider Demographics
NPI:1497160022
Name:PORTER, ELIZABETH S (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:PORTER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3471 5TH AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3215
Mailing Address - Country:US
Mailing Address - Phone:412-692-2360
Mailing Address - Fax:412-692-2370
Practice Address - Street 1:3471 5TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3215
Practice Address - Country:US
Practice Address - Phone:412-692-2360
Practice Address - Fax:412-692-2370
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038756Y207QG0300X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030536000001Medicaid
PA1030536000001Medicaid