Provider Demographics
NPI:1861757304
Name:DORSCHNER TOMLIN, KRISTL VIDYA (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTL
Middle Name:VIDYA
Last Name:DORSCHNER TOMLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTL
Other - Middle Name:VIDYA
Other - Last Name:DORSCHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 843035
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-3035
Mailing Address - Country:US
Mailing Address - Phone:757-668-7200
Mailing Address - Fax:757-668-9663
Practice Address - Street 1:1924 LANDSTOWN CENTRE WAY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-1624
Practice Address - Country:US
Practice Address - Phone:757-668-9330
Practice Address - Fax:757-668-7721
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101282257207V00000X
AZ207V00000X207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR73465OtherTRAINING PERMIT
SC408213Medicaid