Provider Demographics
NPI:1831368406
Name:DUBEL, JAMES WALTER (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WALTER
Last Name:DUBEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PINE ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-6104
Mailing Address - Country:US
Mailing Address - Phone:731-747-4646
Mailing Address - Fax:732-747-9749
Practice Address - Street 1:410 PINE ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-6104
Practice Address - Country:US
Practice Address - Phone:731-747-4646
Practice Address - Fax:732-747-9749
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00230400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ501705Medicare PIN