Provider Demographics
NPI:1629369640
Name:BRCHAN, DORLYNE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:DORLYNE
Middle Name:MICHELLE
Last Name:BRCHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5750 E HIGHWAY 90 STE 200
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-9113
Mailing Address - Country:US
Mailing Address - Phone:520-263-3670
Mailing Address - Fax:520-263-3671
Practice Address - Street 1:5750 E HIGHWAY 90 STE 200
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-9113
Practice Address - Country:US
Practice Address - Phone:520-263-3670
Practice Address - Fax:202-633-6715
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ701682084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1648501Medicaid
AKK167608Medicare PIN