Provider Demographics
NPI:1811926181
Name:DORRY, SUSAN (DPM)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:DORRY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-2172
Mailing Address - Country:US
Mailing Address - Phone:508-291-0699
Mailing Address - Fax:508-291-0690
Practice Address - Street 1:268 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2172
Practice Address - Country:US
Practice Address - Phone:508-291-0699
Practice Address - Fax:508-291-0690
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2071213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA791591OtherTUFTS HEALTH PLAN
MA000000030299OtherHEALTHNET
MA334068OtherHARVARD PILGRIM HEALTH
MAY71018OtherBLUE SHEILD OF MA
MA27-04262OtherUNITED HEALTH CARE
MA000000030299OtherHEALTHNET
MAU63905Medicare UPIN
MA791591OtherTUFTS HEALTH PLAN
MA334068OtherHARVARD PILGRIM HEALTH