Provider Demographics
NPI:1982026837
Name:MARI WARGO-DORSEY, DPM
Entity Type:Organization
Organization Name:MARI WARGO-DORSEY, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:MARI
Authorized Official - Middle Name:
Authorized Official - Last Name:WARGO-DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-422-4199
Mailing Address - Street 1:512 BRADEN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1610
Mailing Address - Country:US
Mailing Address - Phone:724-422-4199
Mailing Address - Fax:724-581-4606
Practice Address - Street 1:512 BRADEN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1610
Practice Address - Country:US
Practice Address - Phone:724-422-4199
Practice Address - Fax:724-581-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006043302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization