Provider Demographics
NPI:1093162315
Name:DUBUQUE, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DUBUQUE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 ARTHURSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HARTLY
Mailing Address - State:DE
Mailing Address - Zip Code:19953-3102
Mailing Address - Country:US
Mailing Address - Phone:302-588-2798
Mailing Address - Fax:
Practice Address - Street 1:2990 ARTHURSVILLE RD
Practice Address - Street 2:
Practice Address - City:HARTLY
Practice Address - State:DE
Practice Address - Zip Code:19953-3102
Practice Address - Country:US
Practice Address - Phone:302-588-2798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0040438163WD1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal