Provider Demographics
NPI:1437181864
Name:DORSCH, TERRYL (DPM)
Entity Type:Individual
Prefix:DR
First Name:TERRYL
Middle Name:
Last Name:DORSCH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 RESNIK RD STE 107
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4843
Mailing Address - Country:US
Mailing Address - Phone:508-747-3567
Mailing Address - Fax:508-830-1224
Practice Address - Street 1:45 RESNIK RD STE 107
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4843
Practice Address - Country:US
Practice Address - Phone:508-747-3567
Practice Address - Fax:508-830-1224
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2018-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2352213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA145143OtherHARVARD PILGRIM
U16869Medicare UPIN