Provider Demographics
NPI:1851355986
Name:BULLINS, DOROTHY V
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:V
Last Name:BULLINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-8424
Mailing Address - Country:US
Mailing Address - Phone:704-638-4443
Mailing Address - Fax:704-638-4443
Practice Address - Street 1:315 GRANT RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-8424
Practice Address - Country:US
Practice Address - Phone:704-638-4443
Practice Address - Fax:704-638-4443
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC19732225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7703005Medicaid
NC0438VOtherBCBS
NC1094720001Medicare NSC