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Douglas R Port, DO
Diagnostic Radiology Physician in Milwaukee, Wisconsin
NPI 1932121191

Douglas R Port is a Diagnostic Radiology Physician based in Milwaukee, WI and is specialized in Diagnostic Radiology. Douglas R Port practices in Milwaukee, WI and has the professional credentials of DO. The NPI Number for Douglas R Port is 1932121191 and holds a License No. 42020-021 (Wisconsin).

The current practice location address for Douglas R Port is 111 E Wisconsin Ave, Milwaukee, WI and can be reached out via phone at 414-290-6720 and via fax at 414-290-6755.

Location: 111 E Wisconsin Ave, Milwaukee, WI, 53202-4815
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932121191
Provider Name
Douglas R Port
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
111 E Wisconsin Ave, Milwaukee, WI, 53202-4815
Phone Number
414-290-6720
Fax Number
414-290-6755
Provider Enumeration Date
07/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
300113936 01 WI MEDICARE RAILROAD
34004200 05 WI
institution
Provider Business Practice Location Address Details
Address
111 E Wisconsin Ave
City
Milwaukee
State
Wisconsin
Zip
53202-4815
Phone Number
414-290-6720
Fax Number
414-290-6755
person
Provider Business Mailing Address Details
Address
111 E Wisconsin Ave
City
Milwaukee
State
Wisconsin
Zip
53202-4815
Phone Number
414-290-6720
Fax Number
414-290-6755
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
42020-021 (Wisconsin)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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