Organization
DAVID K. DORMAN, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID K DORMAN M.D. (PRESIDENT)
(262) 782-4144
Entity
Organization
Contact information
Practice address
19475 W NORTH AVE, SUITE 302, BROOKFIELD, WI 53045-4199
(262) 782-4144
(262) 782-5854
Mailing address
19475 W NORTH AVE, SUITE 302, BROOKFIELD, WI 53045-4199
(262) 782-4144
(262) 782-5854
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
16979-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30203100
—
WI
Enumeration date
10/24/2006
Last updated
08/22/2020
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