Mary Dolores Dvorak, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD042672L Issued in PA

Practice address

90 Hope Dr
366 MDG/SGH
Mountain Home a F B, ID 83648-1057

Phone

(208) 828-7655

NPI assigned

Aug 19, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780676239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 CAMBRIDGE ST",
            "city": "NATRONA HEIGHTS",
            "state": "PA",
            "postal_code": "150651306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR",
            "address_2": "366 MDG/SGH",
            "city": "MOUNTAIN HOME A F B",
            "state": "ID",
            "postal_code": "836481057",
            "telephone_number": "208-828-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "MARY",
        "middle_name": "DOLORES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD042672L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Lee Burns, IDMT
• Travis Wade Cronin, LCSW
• Joe Cabalhin Dittman, IDMT
• Omar D Hernandez Solano, IDMT
• Amy Jo Hicks
• Jennifer Lynn Hudson, D.O.
• Joseph Paul Keddie, IDMT
• Kristen Anne Lewis

• Internal Medicine Physician in Mountain Home a F B, ID
• Providers in Mountain Home a F B, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.