Provider Demographics
NPI:1164106134
Name:JOHN BUBSER DPM PA
Entity Type:Organization
Organization Name:JOHN BUBSER DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:BUBSER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-499-3338
Mailing Address - Street 1:PO BOX 806
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-0806
Mailing Address - Country:US
Mailing Address - Phone:410-257-3558
Mailing Address - Fax:
Practice Address - Street 1:10264 SOUTHERN MARYLAND BLVD
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-3037
Practice Address - Country:US
Practice Address - Phone:410-257-3558
Practice Address - Fax:410-257-3524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty