Provider Demographics
NPI:1568521458
Name:TAMAGNE, DORI P (MD)
Entity Type:Individual
Prefix:DR
First Name:DORI
Middle Name:P
Last Name:TAMAGNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR LBBY J2000
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:
Practice Address - Street 1:IHA BROOKLYN PRIMARY CARE
Practice Address - Street 2:SUITE A
Practice Address - City:BROOKLYN
Practice Address - State:MI
Practice Address - Zip Code:49230-4923
Practice Address - Country:US
Practice Address - Phone:517-592-8033
Practice Address - Fax:517-592-3959
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2020-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301072273207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine