Individual
ERIC M DORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
(414) 434-0461
Mailing address
10945 N PORT WASHINGTON RD STE 201, MEQUON, WI 53092-5078
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
42422
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34505000
—
WI
Enumeration date
11/29/2005
Last updated
06/05/2025
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