Provider Demographics
NPI:1639399082
Name:DOBERSEN, MICHAEL JOSEPH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:DOBERSEN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7731 S WINDERMERE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8000
Mailing Address - Country:US
Mailing Address - Phone:303-795-7611
Mailing Address - Fax:720-874-3627
Practice Address - Street 1:ARAPAHOE COUNTY CORONER'S OFFICE
Practice Address - Street 2:13101-E. BRONCO'S PKWY
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4668
Practice Address - Country:US
Practice Address - Phone:720-874-3625
Practice Address - Fax:720-874-3627
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30921207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology