Provider Demographics
NPI:1437102621
Name:DOBZYNIAK, MATTHEW A (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:DOBZYNIAK
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:PO BOX 71690
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23255-1690
Mailing Address - Country:US
Mailing Address - Phone:804-285-2300
Mailing Address - Fax:804-285-8420
Practice Address - Street 1:1501 MAPLE AVE
Practice Address - Street 2:NW MOB SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2553
Practice Address - Country:US
Practice Address - Phone:804-285-2300
Practice Address - Fax:804-285-8420
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236061174400000X
VA01011236061207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA173232OtherANTHEM
VA010074096Medicaid
VA173232OtherANTHEM
H43439Medicare UPIN