Provider Demographics
NPI:1477551711
Name:DOBYAN, DENNIS CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CHARLES
Last Name:DOBYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1009 W SAINT MAARTENS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-2990
Mailing Address - Country:US
Mailing Address - Phone:816-232-8145
Mailing Address - Fax:816-279-1840
Practice Address - Street 1:1009 W SAINT MAARTENS DR
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2989
Practice Address - Country:US
Practice Address - Phone:816-232-8145
Practice Address - Fax:816-279-1840
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO105260207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F31861Medicare UPIN
MO5284426Medicare PIN