Provider Demographics
NPI:1417920489
Name:DUBYNSKY, OREST G (MD)
Entity Type:Individual
Prefix:DR
First Name:OREST
Middle Name:G
Last Name:DUBYNSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 29TH AVENUE PL STE 101
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6800
Mailing Address - Country:US
Mailing Address - Phone:970-356-2600
Mailing Address - Fax:970-356-2633
Practice Address - Street 1:1610 29TH AVENUE PL STE 101
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6800
Practice Address - Country:US
Practice Address - Phone:970-356-2600
Practice Address - Fax:970-356-2633
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO032412174400000X
CODR0032412208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01324128Medicaid
CO01324128Medicaid