| Doctor Name: | NATHANIEL DORE |
| NPI Number: | 1134503592 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | COA.17683-NP |
| Business Practice Address: | 20050 Harvard Ave Suite 300 Warrensville Heights, OH - 441226816 |
| Business Phone Number: | 2167511212 |
| Business Fax Number: | |
| Mailing Address: | 7675 Saratoga Rd, MIDDLEBURG HEIGHTS |
| State: | OH |
| Postal Code: | 441306675 |
| Phone Number: | 4406337403 |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2015 |
| NPI Last Update Date: | 07/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | COA.17683-NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |