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Individual

HEATHER S DOLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4160 JOHN R, HARPER PROFESSIONAL BLDG STE 615, DETROIT, MI 48201
(313) 745-4195
(313) 993-8669
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING, TROY, MI 48083-1138
(313) 745-4195
(313) 993-8669

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301076367
MI
2086S0102X
Surgical Critical Care Physician
Primary
4301076367
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
987653000
MN
01
P00427429
RAILROAD MEDICARE
MN
Enumeration date
08/04/2006
Last updated
10/25/2016
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