Provider Demographics
NPI:1629175666
Name:RICHLAND ENDOCRINOLOGY & DIABETES CENTER INC
Entity Type:Organization
Organization Name:RICHLAND ENDOCRINOLOGY & DIABETES CENTER INC
Other - Org Name:RICHLAND ENDOCRINOLOGY & DIABETES CENTER INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-522-2734
Mailing Address - Street 1:295 GLESSNER AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903
Mailing Address - Country:US
Mailing Address - Phone:419-522-2734
Mailing Address - Fax:419-522-2260
Practice Address - Street 1:295 GLESSNER AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903
Practice Address - Country:US
Practice Address - Phone:419-522-2734
Practice Address - Fax:419-522-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty