Provider Demographics
NPI:1538229075
Name:DOROKHINE, IGOR (MD)
Entity type:Individual
Prefix:
First Name:IGOR
Middle Name:
Last Name:DOROKHINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 CHESTER PIKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CRUM LYNNE
Mailing Address - State:PA
Mailing Address - Zip Code:19022-1022
Mailing Address - Country:US
Mailing Address - Phone:610-499-7180
Mailing Address - Fax:610-876-0859
Practice Address - Street 1:1553 CHESTER PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:CRUM LYNNE
Practice Address - State:PA
Practice Address - Zip Code:19022-1022
Practice Address - Country:US
Practice Address - Phone:610-499-7180
Practice Address - Fax:610-876-0859
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD430069207Q00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine