Provider Demographics
NPI:1669419297
Name:DOBKIN, LARRY A (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:A
Last Name:DOBKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 MURRAY AVENUE
Mailing Address - Street 2:SUITE #8158
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217
Mailing Address - Country:US
Mailing Address - Phone:412-889-3747
Mailing Address - Fax:
Practice Address - Street 1:1800 MURRAY AVENUE
Practice Address - Street 2:SUITE #8158
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217
Practice Address - Country:US
Practice Address - Phone:412-889-3747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025812E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DO014264OtherHIGHMARK
1000525OtherGATEWAY
PA0009514480003Medicaid
516718Medicare ID - Type Unspecified
1000525OtherGATEWAY