Provider Demographics
NPI:1598722449
Name:DUBOIS, DENNIS P (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:P
Last Name:DUBOIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-857-8666
Mailing Address - Fax:716-857-8944
Practice Address - Street 1:85 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1149
Practice Address - Country:US
Practice Address - Phone:716-857-8610
Practice Address - Fax:716-250-5944
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY109610-1207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00481154Medicaid
NY00010048801OtherUNIVERA
NY2100159OtherIHA
NY39988OtherGHI
NY109610-6BOtherWORKERS COMPENSATION
NY000510015003OtherHEALTH NOW
NY109610-6BOtherWORKERS COMPENSATION
NY000510015003OtherHEALTH NOW