MEDICARE: TRISHA DORAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	35.086200	OH

General Provider Information

NPI Number	:	1164573317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISHA DORAN M.D.

Provider Business Mailing Address
First Line	:	102 W MAIN ST UNIT 443
Second Line	:
City	:	NEW ALBANY
State	:	OH
Zip	:	43054-9162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 PARK EAST DR
Second Line	:	STE 100
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4339
Country	:	US
Telephone Number	:	216-593-7700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	05/28/2021

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