1588725279 NPI number — MARIE A DOBYNS MD PA

Table of content: (NPI 1588725279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588725279 NPI number — MARIE A DOBYNS MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARIE A DOBYNS MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588725279
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7350 VAN DUSEN RD
Provider Second Line Business Mailing Address:
SUITE 320
Provider Business Mailing Address City Name:
LAUREL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20707-5264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-725-0788
Provider Business Mailing Address Fax Number:
301-725-2779

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7350 VAN DUSEN RD
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
LAUREL
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20707-5264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-725-0788
Provider Business Practice Location Address Fax Number:
301-725-2779
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DOBYNS
Authorized Official First Name:
MARIE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRACTICE OWNER
Authorized Official Telephone Number:
301-725-0788

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  D0029923 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 288803301 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com