MEDICARE: DOPPLER ALLIANCE LLC

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	261QM1300X	Multi-Specialty Clinic/Center	134552-8080	VA

General Provider Information

NPI Number	:	1609168905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOPPLER ALLIANCE LLC

Provider Business Mailing Address
First Line	:	4772 EUCLID RD STE D
Second Line	:
City	:	VIRGINIA BCH
State	:	VA
Zip	:	23462-3800
Country	:	US
Telephone Number	:	757-685-7232
Fax Number	:

Provider Business Practice Location Address
First Line	:	4772 EUCLID RD STE D
Second Line	:
City	:	VIRGINIA BCH
State	:	VA
Zip	:	23462-3800
Country	:	US
Telephone Number	:	757-685-7232
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SHENEKIA M BAKER
Credential	:	RVT
Telephone Number	:	757-685-7232

Provider Enumeration Date	:	05/05/2011
Last Update Date	:	06/02/2011

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