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1962405670

NPI Code Detail

MEDICARE: DR. AUGUSTIN DOLORFINO MD

MEDICARE: DR. AUGUSTIN DOLORFINO MD

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	4301406733	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	120877	OTHER	MI	PREFFERED CHOICE BILLING
2	AD406733	OTHER	MI	BLUE CROSS BILLING NUMBER
3	19788	OTHER	MI	PRIORITY HEALTH BILLING
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4085098	OTHER	MI	MOLINA

General Provider Information

NPI Number	:	1962405670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUGUSTIN DOLORFINO MD

Provider Business Mailing Address
First Line	:	307 LAKEWOOD DR
Second Line	:
City	:	CADILLAC
State	:	MI
Zip	:	49601-8502
Country	:	US
Telephone Number	:	231-878-8237
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 COBB ST
Second Line	:
City	:	CADILLAC
State	:	MI
Zip	:	49601-2588
Country	:	US
Telephone Number	:	231-775-6521
Fax Number	:	231-876-6519

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/11/2023

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Directions to “ DR. AUGUSTIN DOLORFINO MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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