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General NPI Number Information
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NPI Number | 1508870221
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Entity Type | Individual
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Provider Name | JENNIFER L DORANTES MD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 11911 N MERIDIAN ST STE 110
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City | CARMEL
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State | IN
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Zip | 46032-6919
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Country | US
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Telephone | 317-621-6800
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Fax | 317-621-6808
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Provider Business Mailing Address
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Address Line | 280 CHESTNUT ST 2ND FLOOR
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City | SPRINGFIELD
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State | MA
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Zip | 01199-1001
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Country | US
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Telephone | 413-794-5700
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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 | 223928
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License Number State | MA
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