Provider Demographics
NPI:1982594354
Name:DORMELUS, OBDIEL
Entity type:Individual
Prefix:
First Name:OBDIEL
Middle Name:
Last Name:DORMELUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 PARK AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4217
Mailing Address - Country:US
Mailing Address - Phone:334-498-2319
Mailing Address - Fax:
Practice Address - Street 1:110 E GROVE ST
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-1117
Practice Address - Country:US
Practice Address - Phone:334-498-2319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter