Provider Demographics
NPI:1548453947
Name:DORF BIDERMAN, NATALIA (MD)
Entity type:Individual
Prefix:MRS
First Name:NATALIA
Middle Name:
Last Name:DORF BIDERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 EXCELSIOR BLVD STE #2-260
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426
Mailing Address - Country:US
Mailing Address - Phone:952-993-6495
Mailing Address - Fax:952-993-6609
Practice Address - Street 1:6500 EXCELSIOR BLVD STE #2-260
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-993-6495
Practice Address - Fax:952-993-6609
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52577207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine