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General NPI Number Information
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NPI Number | 1437150752
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Entity Type | Individual
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Provider Name | KEVIN ARNOLD DORRANCE MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 7616 CULEBRA RD SUITE 130
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City | SAN ANTONIO
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State | TX
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Zip | 78251
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Country | US
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Telephone | 726-201-3660
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Fax |
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Provider Business Mailing Address
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Address Line | 25714 RIDGE ROAD
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City | DAMASCUS
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State | MD
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Zip | 20872-1852
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Country | US
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Telephone | 240-731-8330
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 52862
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | V4104
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License Number State | TX
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