Healthcare Provider Details

I. General information

NPI: 1588046858
Provider Name (Legal Business Name): DOROTA MARCHEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 STONE RD
ANN ARBOR MI
48105-2534
US

IV. Provider business mailing address

135 RUTLEDGE AVE
CHARLESTON SC
29425-8903
US

V. Phone/Fax

Practice location:
  • Phone: 248-495-3570
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL38547
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD2022-0394
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: