Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207NS0135X | Procedural Dermatology | 35.048938 | OH |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35.048938 | OH |
Y | 207QA0505X | Family Doctor - Adult Medicine | 35.048938 | OH |
N | 208D00000X | General Practice Physician | 35.048938 | OH |
NPI | 1336170851 |
---|---|
Provider Name | Dr. Doreen Dupont |
First Address | Dublin, OH 43017-1343 |
Second Address | Dublin, OH 43017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 24/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A15591 | (02) | FL |