Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Andrea Jo Poulson-Port, MD

Individual provider Family Medicine Physician · NPI 1326280611

Andrea Jo Poulson-Port, MD is a Family Practice in Manitowoc, Wisconsin. Graduated from Wayne State University School of Medicine in 2009, 17 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group. Licensed in Wisconsin.

Years since qualifying
17
Trained at
Wayne State University School of Medicine
Licensed in
WI
In the registry since
2009
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4100 Dewey St
Manitowoc, WI 54220-5497
Phone: (920) 686-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 56118-20 (WI)

Record details

NPI number1326280611
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 1, 2009
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2009 (17 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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