Provider Demographics
NPI:1992036867
Name:DOROSHOW, KATY MICHELLE (DO)
Entity Type:Individual
Prefix:DR
First Name:KATY
Middle Name:MICHELLE
Last Name:DOROSHOW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 307 MOB SOUTH
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:484-572-2444
Mailing Address - Fax:484-572-0495
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 307 MOB SOUTH
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-572-2444
Practice Address - Fax:484-572-0495
Is Sole Proprietor?:No
Enumeration Date:2010-01-16
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS016301207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology