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General NPI Number Information
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NPI Number | 1104087980
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Entity Type | Individual
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Provider Name | MARI ELIZABETH WARGO-DORSEY DPM
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Gender | Female
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 9218 ROUTE 119 HWY S
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City | BLAIRSVILLE
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State | PA
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Zip | 15717-8849
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Country | US
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Telephone | 724-762-7621
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Fax |
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Provider Business Mailing Address
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Address Line | 9218 ROUTE 119 HWY S
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City | BLAIRSVILLE
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State | PA
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Zip | 15717-8849
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Country | US
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Telephone | 724-762-7621
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Fax |
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | SC006043
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License Number State | PA
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