Healthcare Provider Details

I. General information

NPI: 1417726035
Provider Name (Legal Business Name): DORINE MARCELLUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7310 RITCHIE HWY # 200
GLEN BURNIE MD
21061-3065
US

IV. Provider business mailing address

7607 AUSTIN WOODS LN
GLEN BURNIE MD
21060-8918
US

V. Phone/Fax

Practice location:
  • Phone: 108-913-9814
  • Fax:
Mailing address:
  • Phone: 516-265-2012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: