Individual
WALTER HOLLIFIELD DORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7600 FRANCE AVE S STE 5100, EDINA, MN 55435
(952) 893-1959
(952) 893-1954
Mailing address
7600 FRANCE AVE S STE 5100, EDINA, MN 55435-5924
(952) 893-1959
(952) 893-1954
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
21028
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106158C477
UCARE
MN
01
—
24909
AMERICA'S PPO
MN
01
—
3200021
MEDICA
MN
01
—
411774839A002
CHAMPUS
MN
01
—
660003751
RR MEDICARE
MN
01
—
66Q38DO
BLUE CROSS BLUE SHIELD
MN
05
—
685592000
—
MN
01
—
960080460002
PREFERRED ONE
MN
01
—
965162
AFFORDABLE NETWORK
MN
01
—
HP13178
HEALTHPARTNERS
MN
Enumeration date
06/09/2005
Last updated
11/18/2020
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