Provider Demographics
NPI:1437150752
Name:DORRANCE, KEVIN ARNOLD (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ARNOLD
Last Name:DORRANCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:25714 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-1852
Mailing Address - Country:US
Mailing Address - Phone:240-731-8330
Mailing Address - Fax:
Practice Address - Street 1:7616 CULEBRA RD
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:726-201-3660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD52862207R00000X
TXV4104207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine