Provider Demographics
NPI:1558363531
Name:COREY, DORIS DIPRIMIO (DO)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:DIPRIMIO
Last Name:COREY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 REGAL OAKS CIRCLE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202
Mailing Address - Country:US
Mailing Address - Phone:330-474-1351
Mailing Address - Fax:
Practice Address - Street 1:2365 EDISON BLVD
Practice Address - Street 2:TWINSBURG URGENT CARE
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087
Practice Address - Country:US
Practice Address - Phone:330-425-4385
Practice Address - Fax:330-963-4783
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:2006-06-05
Deactivation Code:
Reactivation Date:2006-11-06
Provider Licenses
StateLicense IDTaxonomies
OH34007478207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2306927Medicaid
OH2306927Medicaid
OH4070361Medicare ID - Type Unspecified