Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | F140678 | WV |
NPI | 1003105966 |
---|---|
Provider Name | Dr. Nicole Lee Dorinzi |
First Address | Morgantown, WV 26506-9149 |
Second Address | Morgantown, WV 26506-9149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2011 |
Last Update Date | 31/03/2011 |