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Individual

MICHAEL ROBERT DORWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8805 N MERIDIAN ST, INDIANAPOLIS, IN 46260-2760
(317) 706-7246
(317) 706-3417
Mailing address
8805 N MERIDIAN ST, INDIANAPOLIS, IN 46260-2760
(317) 706-7246
(317) 706-3417

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01064446A
IN
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
01064446A
IN
208VP0014X
Interventional Pain Medicine Physician
Primary
01064446A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000715005
ANTHEM
IN
01
01064446A
STATE LICENSE NUMBER
IN
05
201020000
IN
01
M400046439
MEDICARE PTAN
IN
Enumeration date
05/14/2007
Last updated
05/19/2025
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