Provider Demographics
NPI:1043575079
Name:DOLLIN, MICHAEL LEO (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEO
Last Name:DOLLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:840 WALNUT ST
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-928-3300
Mailing Address - Fax:215-825-4723
Practice Address - Street 1:840 WALNUT ST
Practice Address - Street 2:SUITE 1020
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5109
Practice Address - Country:US
Practice Address - Phone:215-928-3300
Practice Address - Fax:215-825-4723
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD444315207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology