WALTER HOLLIFIELD DORMAN M.D. NPI 1902800873

NPI Information

NPI: 1902800873
Provider Name: WALTER HOLLIFIELD DORMAN, M.D.
Classification: Internal Medicine - 207RR0500X
Entity Type: Individual

Specialization: Rheumatology

PECOS Registration: Yes

Address:
7600 FRANCE AVE S STE 5100
EDINA, MN
ZIP 55435
Phone: (952) 893-1959
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Walter Hollifield Dorman, M.D. is a rheumatology internal medicine in Edina, MN. The provider is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. Walter Hollifield Dorman, M.D. NPI is 1902800873. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7600 FRANCE AVE S STE 5100
EDINA, MN
ZIP 55435
Phone: (952) 893-1959
Fax: (952) 893-1954

The NPI 1902800873 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/9/2005 and was last updated on 11/18/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RR0500X	Internal Medicine	Rheumatology	21028	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	411774839A002	OTHER	MINNESOTA	CHAMPUS
2	660003751	OTHER	MINNESOTA	RR MEDICARE
3	965162	OTHER	MINNESOTA	AFFORDABLE NETWORK
4	66Q38DO	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
5	24909	OTHER	MINNESOTA	AMERICA'S PPO
6	3200021	OTHER	MINNESOTA	MEDICA
7	685592000	MEDICAID	MINNESOTA
8	960080460002	OTHER	MINNESOTA	PREFERRED ONE
9	HP13178	OTHER	MINNESOTA	HEALTHPARTNERS
10	106158C477	OTHER	MINNESOTA	UCARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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