Provider Demographics
NPI:1023140092
Name:DOBAS, DANIEL C (DPM)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:C
Last Name:DOBAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 MEADOW BROOK RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-4924
Mailing Address - Country:US
Mailing Address - Phone:203-218-4922
Mailing Address - Fax:
Practice Address - Street 1:193 MEADOW BROOK RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:CT
Practice Address - Zip Code:06478-4924
Practice Address - Country:US
Practice Address - Phone:203-218-4922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000043213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004006250Medicaid
CT004006250Medicaid
T22638Medicare UPIN