1275678963 NPI number — DR. DAVID BARRY DOLBERG D.C.

Table of content: DR. DAVID BARRY DOLBERG D.C. (NPI 1275678963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275678963 NPI number — DR. DAVID BARRY DOLBERG D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOLBERG
Provider First Name:
DAVID
Provider Middle Name:
BARRY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NORMANDY-DOLBERG
Provider Other First Name:
DAVID
Provider Other Middle Name:
BARRY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1275678963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8440 OLD KEENE MILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22152-2302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-569-1300
Provider Business Mailing Address Fax Number:
703-569-1972

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8440 OLD KEENE MILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22152-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-569-1300
Provider Business Practice Location Address Fax Number:
703-569-1972
Provider Enumeration Date:
02/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  0104000354 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0004286516 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 505363 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 849534 . This is a "FOCUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2194700 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460103 . This is a "ASHN (AMER SPEC HEALTH NE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5511403 . This is a "PHCS (PRIVATE HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 428735 . This is a "M.D. IPA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 428735 . This is a "OPTIMUM CHOICE, INC." identifier . This identifiers is of the category "OTHER".
  • Identifier: 460146 . This is a "ACN GROUP, INC." identifier . This identifiers is of the category "OTHER".
  • Identifier: 23938011 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2989101001 . This is a "CIGNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 428735 . This is a "ONE NET PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113695 . This is a "KAISER PERMANENTE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 428735 . This is a "MAMSI LIFE & HEALTH INS C" identifier . This identifiers is of the category "OTHER".
  • Identifier: 119987 . This is a "ANTHEM BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 9650540-001 . This is a "CIGNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: P-11117130 . This is a "MULTIPLAN, INC." identifier . This identifiers is of the category "OTHER".
  • Identifier: H838-0001 . This is a "CARE FIRST BCBS" identifier . This identifiers is of the category "OTHER".




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