Healthcare Provider Details

I. General information

NPI: 1538160452
Provider Name (Legal Business Name): JOHN M. DOBROWSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 CHARLES ST
BOSTON MA
02114-3002
US

IV. Provider business mailing address

243 CHARLES ST
BOSTON MA
02114-3002
US

V. Phone/Fax

Practice location:
  • Phone: 617-573-4104
  • Fax: 617-573-3914
Mailing address:
  • Phone: 617-573-4104
  • Fax: 617-573-3914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number252443
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number252443
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: