Provider Demographics
NPI:1841229994
Name:DUBOWY, SUSAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:DUBOWY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ROCKLAND RD
Mailing Address - Street 2:DEPARTMENT OF ORTHOPEDICS, DUPONT HOSPITAL
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3607
Mailing Address - Country:US
Mailing Address - Phone:302-651-5913
Mailing Address - Fax:717-859-2898
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:DEPARTMENT OF ORTHOPEDICS, DUPONT HOSPITAL
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-5913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000556363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50051188OtherCAPITAL BLUE CROSS
PAS51497Medicare UPIN
PA50051188OtherCAPITAL BLUE CROSS