| Doctor Name: | JOSHUA M DORN |
| NPI Number: | 1346683687 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | A101035017202 |
| Business Practice Address: | 820 Emerald St #122 Saint Paul, MN - 551141062 |
| Business Phone Number: | 6517073152 |
| Business Fax Number: | |
| Mailing Address: | 701 Park Ave, MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554151623 |
| Phone Number: | 6128736963 |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2013 |
| NPI Last Update Date: | 04/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | A101035017202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |