Provider Demographics
NPI:1902919988
Name:DORROH, MARTHA E (NP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:E
Last Name:DORROH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:SUSAN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1515 SW CARY PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6224
Mailing Address - Country:US
Mailing Address - Phone:919-387-3180
Mailing Address - Fax:919-387-3145
Practice Address - Street 1:1515 SW CARY PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6224
Practice Address - Country:US
Practice Address - Phone:919-387-3180
Practice Address - Fax:919-387-3145
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003860Medicaid
NC7003860Medicaid
NC2593443AMedicare PIN