Provider Demographics
NPI:1205868684
Name:DORSEY, STEVEN ELLIOTT (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ELLIOTT
Last Name:DORSEY
Suffix:
Gender:M
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:844-266-8268
Mailing Address - Fax:
Practice Address - Street 1:3129 SPRINGBANK LN STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3379
Practice Address - Country:US
Practice Address - Phone:704-384-5151
Practice Address - Fax:704-316-2905
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401049208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN0104AMedicaid
NC891372CMedicaid
NC1205868684Medicaid
NC1372COtherBCBS
NC891372CMedicaid