Provider Demographics
NPI:1720283740
Name:MICHEL, DOROTHY MARIE (ARDMS)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:MARIE
Last Name:MICHEL
Suffix:
Gender:F
Credentials:ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8152 MEADOW BEND DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46259-6731
Mailing Address - Country:US
Mailing Address - Phone:317-626-3853
Mailing Address - Fax:
Practice Address - Street 1:8152 MEADOW BEND DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46259-6731
Practice Address - Country:US
Practice Address - Phone:317-626-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1266662471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography