Provider Demographics
NPI:1003861758
Name:DUBOWITCH, STUART G (DO)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:G
Last Name:DUBOWITCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8566
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-0566
Mailing Address - Country:US
Mailing Address - Phone:856-663-7080
Mailing Address - Fax:856-663-4945
Practice Address - Street 1:2201 CHAPEL AVE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-663-7080
Practice Address - Fax:856-663-4945
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB42870207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC54434Medicare UPIN
NJ506619Medicare ID - Type Unspecified