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General NPI Number Information
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NPI Number | 1306272869
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Entity Type | Organization
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Legal Business Name | DORSAM & GENERIE, OD, LLC
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Dates
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Enumeration Date | 09/16/2013
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 6230 OLD DOBBIN LN STE 190
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City | COLUMBIA
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State | MD
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Zip | 21045-5954
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Country | US
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Telephone | 443-420-8113
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Fax | 443-973-6998
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Provider Business Mailing Address
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Address Line | 5725 RICHARDS VALLEY RD STE A9
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6964
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Country | US
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Telephone | 443-420-8113
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Fax | 443-420-8113
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. CHRISTINA GENERIE
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Credential | O.D.
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Telephone | 443-420-8113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | TA1997
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License Number State | MD
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