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Individual

HAZEL ANN M DORONILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2800 BLUE RIDGE RD STE 201, RALEIGH, NC 27607-6477
(919) 784-7110
(919) 784-7111
Mailing address
2800 BLUE RIDGE RD STE 201, RALEIGH, NC 27607-6477
(919) 784-7110
(919) 784-7111

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06898
NC
363AS0400X
Surgical Physician Assistant
015026
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03580169
NY
01
J400086012
MEDICARE PTAN
NY
01
P01218526
RAIL ROAD MEDICARE
NY
Enumeration date
08/22/2011
Last updated
07/21/2022
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