Basic Information
Provider Information
NPI: 1447697123
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DORSEY
FirstName: AMELIA
MiddleName: N
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 METROHEALTH DR
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber:  
Practice Location
Address1: 2500 METROHEALTH DR
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441091900
CountryCode: US
TelephoneNumber: 2167787800
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2013
LastUpdateDate: 12/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XA157419CAY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home