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General NPI Number Information
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NPI Number | 1306428545
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Entity Type | Individual
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Provider Name | MICHAEL DORRITIE DO
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Gender | Male
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 622 W 168TH ST STE VC-260
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City | NEW YORK
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State | NY
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Zip | 10032-3720
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Country | US
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Telephone | 212-305-6059
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3714
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Country | US
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Telephone | 312-864-6000
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 125.077616
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 335562
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License Number State | NY
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