Individual
ANDREW TERRENCE DORIS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-3495
Mailing address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-3495
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
049005
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000887873A
PEACHSTATE
GA
01
—
00887873A
WELLCARE
GA
05
—
00887873A
—
GA
01
—
160054730
PALMETTO GBA RAILROAD
GA
01
—
728963
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/22/2007
Last updated
01/31/2012
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