Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 35-037910 | OH |
NPI | 1578580510 |
---|---|
Provider Name | Dorr G Dearborn |
First Address | Euclid, OH 44117-1714 |
Second Address | Cleveland, OH 44106-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 21/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000028322 | ANTHEM (01) | OH |
000000221399 | UNISON (01) | OH |
000000525904 | ANTHEM (01) | OH |
0559328 | (05) | OH |
0559328 | BCMH (01) | OH |
0639605 | AETNA (01) | OH |
363468 | WELLLCARE (01) | OH |
370001912 | RAILROAD MEDICARE (01) | OH |
745898 | BUCKEYE (01) | OH |
A82466 | (02) | OH |