Provider Demographics
NPI: | 1477046647 |
---|---|
Name: | JOHN F DOMBROWSKI MD PC |
Entity Type: | Organization |
Organization Name: | JOHN F DOMBROWSKI MD PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICIAN |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | FRANCIS |
Authorized Official - Last Name: | DOMBROWSKI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 202-362-4787 |
Mailing Address - Street 1: | 3301 NEW MEXICO AVE NW STE 346 |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20016-3623 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 240-362-3551 |
Mailing Address - Fax: | 202-595-7820 |
Practice Address - Street 1: | 3301 NEW MEXICO AVE NW STE 346 |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20016-3623 |
Practice Address - Country: | US |
Practice Address - Phone: | 240-362-3551 |
Practice Address - Fax: | 202-595-7820 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-06-12 |
Last Update Date: | 2018-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DC | MD21491 | 332900000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332900000X | Suppliers | Non-Pharmacy Dispensing Site |