Provider Demographics
NPI:1548680218
Name:PORUBSKY, CAITLIN FLYNN (DO)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:FLYNN
Last Name:PORUBSKY
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:43151 DALCOMA DR STE 4
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6306
Mailing Address - Country:US
Mailing Address - Phone:586-286-8720
Mailing Address - Fax:
Practice Address - Street 1:2305 GENOA BUSINESS PARK DR STE 180
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7007
Practice Address - Country:US
Practice Address - Phone:810-355-4300
Practice Address - Fax:810-355-4967
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101025158207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology