MEDICARE: JEFFREY M DORF M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	20020026	NM
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	20020026	NM
3	207RP1001X	Pulmonary Disease Physician	20020026	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477571131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY M DORF M.D.

Provider Business Mailing Address
First Line	:	4901 LANG AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4397
Country	:	US
Telephone Number	:	505-842-8171
Fax Number	:	505-246-0684

Provider Business Practice Location Address
First Line	:	4901 LANG AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4495
Country	:	US
Telephone Number	:	505-842-8171
Fax Number	:	505-246-0684

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	08/05/2021

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Directions to “ JEFFREY M DORF M.D.” Practice Location

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