Provider Demographics
NPI:1457686347
Name:DOLDAN, MICHAEL T (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:DOLDAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14240-0488
Mailing Address - Country:US
Mailing Address - Phone:716-646-2590
Mailing Address - Fax:716-646-2593
Practice Address - Street 1:5470 CAMP RD STE 200
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-2756
Practice Address - Country:US
Practice Address - Phone:716-646-2590
Practice Address - Fax:716-646-2593
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY254074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine