Provider Demographics
NPI:1114116498
Name:DOVE, JOSEPH E (DPM)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:DOVE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 BELMAR AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-1900
Mailing Address - Country:US
Mailing Address - Phone:410-242-7066
Mailing Address - Fax:410-242-4126
Practice Address - Street 1:4201 BELMAR AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1900
Practice Address - Country:US
Practice Address - Phone:410-242-7066
Practice Address - Fax:410-242-4126
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01030213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R049 0001OtherBLUE SHIELD FEDERAL
MDS12840192102OtherBLUE SHIELD
MD544008400Medicaid
MDT187JEOtherBLUE SHIELD
MDS12840192102OtherBLUE SHIELD
MD544008400Medicaid
MDT187Medicare PIN
MDCB1030 480018119Medicare PIN