Provider Demographics
NPI:1750463527
Name:DOTZMAN, WILIIAM GREGORY (DO)
Entity Type:Individual
Prefix:DR
First Name:WILIIAM
Middle Name:GREGORY
Last Name:DOTZMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 96TH ST
Mailing Address - Street 2:
Mailing Address - City:STONE HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08247-1404
Mailing Address - Country:US
Mailing Address - Phone:800-441-1189
Mailing Address - Fax:
Practice Address - Street 1:376 96TH ST
Practice Address - Street 2:
Practice Address - City:STONE HARBOR
Practice Address - State:NJ
Practice Address - Zip Code:08247-1404
Practice Address - Country:US
Practice Address - Phone:800-441-1189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB66828207QA0000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Not Answered207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine