Provider Demographics
NPI:1487659082
Name:DUBYOSKI, PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:DUBYOSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W MACPHAIL RD
Mailing Address - Street 2:STE 106
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4393
Mailing Address - Country:US
Mailing Address - Phone:410-638-8900
Mailing Address - Fax:410-638-8915
Practice Address - Street 1:615 W MACPHAIL RD
Practice Address - Street 2:STE 106
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4393
Practice Address - Country:US
Practice Address - Phone:410-638-8900
Practice Address - Fax:410-638-8915
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM18683207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD352131100Medicaid
MDB67254Medicare UPIN
MD352131100Medicaid