Provider Demographics
NPI:1992487375
Name:DORMAN, SHAYLAH (PA)
Entity type:Individual
Prefix:
First Name:SHAYLAH
Middle Name:
Last Name:DORMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:102 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5237
Mailing Address - Country:US
Mailing Address - Phone:401-239-1800
Mailing Address - Fax:401-239-1793
Practice Address - Street 1:102 VALLEY RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5237
Practice Address - Country:US
Practice Address - Phone:401-239-1800
Practice Address - Fax:401-239-1793
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2024-03-18
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant