Provider Demographics
NPI:1013045939
Name:PHILIP D. BOBROW MD PA
Entity Type:Organization
Organization Name:PHILIP D. BOBROW MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BOBROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-657-9876
Mailing Address - Street 1:5530 WISCONSIN AVE
Mailing Address - Street 2:SUITE 1660
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4404
Mailing Address - Country:US
Mailing Address - Phone:301-657-9876
Mailing Address - Fax:301-983-5059
Practice Address - Street 1:5530 WISCONSIN AVE
Practice Address - Street 2:SUITE 1660
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4404
Practice Address - Country:US
Practice Address - Phone:301-657-9876
Practice Address - Fax:301-983-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC824595Medicare PIN
MDB94922Medicare UPIN
0727360001Medicare NSC