Provider Demographics
NPI:1073592069
Name:DUBNER, NEIL P (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:P
Last Name:DUBNER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4127
Mailing Address - Street 2:NEIL P DUBNER MD
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-0127
Mailing Address - Country:US
Mailing Address - Phone:540-981-0672
Mailing Address - Fax:540-344-7154
Practice Address - Street 1:7514 LEE HIGHWAY
Practice Address - Street 2:NEIL P DUBNER MD
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141
Practice Address - Country:US
Practice Address - Phone:540-639-4135
Practice Address - Fax:540-639-6065
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-10-22
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Provider Licenses
StateLicense IDTaxonomies
VA01010401582084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00366125OtherMEDICARE RAILROAD
146385OtherANTHEM
146385OtherANTHEM
P00366125OtherMEDICARE RAILROAD