MEDICARE: STEVEN ELLIOTT DORSEY 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	208000000X	Pediatrics Physician	200401049	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1372C	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1205868684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN ELLIOTT DORSEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	844-266-8268
Fax Number	:

Provider Business Practice Location Address
First Line	:	3129 SPRINGBANK LN STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3379
Country	:	US
Telephone Number	:	704-384-5151
Fax Number	:	704-316-2905

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	01/21/2022

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