Healthcare Provider Details

I. General information

NPI: 1811925878
Provider Name (Legal Business Name): JOHN F DOMBROWSKI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 NEW MEXICO AVE STE 346
NW WASHINGTON DC
20016
US

IV. Provider business mailing address

PO BOX 7096
STOCKTON CA
95267-0096
US

V. Phone/Fax

Practice location:
  • Phone: 202-362-4787
  • Fax: 202-365-4252
Mailing address:
  • Phone: 209-956-7725
  • Fax: 209-956-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberD0048179
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD21491
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberMD21491
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberD0048179
License Number StateMD

VIII. Authorized Official

Name: JOHN F DOMBROWSKI
Title or Position: OWNER
Credential: MD
Phone: 202-362-4787