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General NPI Number Information
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NPI Number | 1043473655
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Entity Type | Individual
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Provider Name | TYANNE LEE DOSH M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | 580 W COLLEGE AVE
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City | MARQUETTE
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State | MI
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Zip | 49855-2736
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Country | US
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Telephone | 906-225-3895
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Fax | 906-225-4562
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Provider Business Mailing Address
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Address Line | 26374 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1263
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Country | US
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Telephone | 906-225-3895
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Fax | 906-225-4562
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 43423
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License Number State | KY
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