Provider Demographics
NPI:1467645705
Name:DOBER, DANA MARIE (DPM)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:DOBER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 REED RD STE B6
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3654
Mailing Address - Country:US
Mailing Address - Phone:484-472-6726
Mailing Address - Fax:484-841-2800
Practice Address - Street 1:590 REED RD STE B6
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008
Practice Address - Country:US
Practice Address - Phone:484-472-6726
Practice Address - Fax:484-841-2800
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005971213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU92961Medicare UPIN