MEDICARE: DOROTHY V BULLINS

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	225000000X	Orthotic Fitter	C19732	NC

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
2	0438V	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1851355986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY V BULLINS

Provider Business Mailing Address
First Line	:	315 GRANT RD
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28146-8424
Country	:	US
Telephone Number	:	704-638-4443
Fax Number	:	704-638-4443

Provider Business Practice Location Address
First Line	:	315 GRANT RD
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28146-8424
Country	:	US
Telephone Number	:	704-638-4443
Fax Number	:	704-638-4443

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	10/07/2008

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