Provider Demographics
NPI:1346229671
Name:BOBROWSKI, THOMAS JOHN (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:BOBROWSKI
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 1:3109 TRENT RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5736
Mailing Address - Country:US
Mailing Address - Phone:252-638-4700
Mailing Address - Fax:252-638-5766
Practice Address - Street 1:3109 TRENT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5736
Practice Address - Country:US
Practice Address - Phone:252-638-4700
Practice Address - Fax:252-638-5766
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC417213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0800UOtherBCBS
NC790800UMedicaid
NC2433402DMedicare ID - Type Unspecified
NC5522520001Medicare NSC
NCU35382Medicare UPIN