Provider Demographics
NPI:1932808102
Name:DOBBINS, MARY ARDEL
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ARDEL
Last Name:DOBBINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 BRAXTON ST
Mailing Address - Street 2:
Mailing Address - City:GASSAWAY
Mailing Address - State:WV
Mailing Address - Zip Code:26624-1413
Mailing Address - Country:US
Mailing Address - Phone:304-402-8534
Mailing Address - Fax:
Practice Address - Street 1:317 BRAXTON ST
Practice Address - Street 2:
Practice Address - City:GASSAWAY
Practice Address - State:WV
Practice Address - Zip Code:26624-1413
Practice Address - Country:US
Practice Address - Phone:304-402-8534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant