Provider Demographics
NPI:1841389905
Name:DOBYNS, MARY MEREDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MEREDITH
Last Name:DOBYNS
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 1:2200 WEST BROAD ST.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-1297
Mailing Address - Country:US
Mailing Address - Phone:614-752-0333
Mailing Address - Fax:614-995-2208
Practice Address - Street 1:2200 WEST BROAD ST.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-1297
Practice Address - Country:US
Practice Address - Phone:614-752-0333
Practice Address - Fax:614-995-2208
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350363882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHST0445441Medicaid
OHST0445441Medicaid
OHDO0756767Medicare PIN