Provider Demographics
NPI:1588643506
Name:DOBBERT, DEAN R (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:R
Last Name:DOBBERT
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 30170
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-7170
Mailing Address - Country:US
Mailing Address - Phone:302-678-9911
Mailing Address - Fax:
Practice Address - Street 1:100 S. MAIN STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1477
Practice Address - Country:US
Practice Address - Phone:302-659-4545
Practice Address - Fax:302-674-3990
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10003096207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000990601Medicaid
E13482Medicare UPIN
DE000990601Medicaid