Provider Demographics
NPI:1699854893
Name:STONE-DORSHOW, TANNI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:TANNI
Middle Name:LYNN
Last Name:STONE-DORSHOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 ELLA LANE
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305
Mailing Address - Country:US
Mailing Address - Phone:952-543-8148
Mailing Address - Fax:952-542-9041
Practice Address - Street 1:2805 ELLA LANE
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:952-543-8148
Practice Address - Fax:952-542-9041
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34566207R00000X
MN31566207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine