Healthcare Provider Details

I. General information

NPI: 1467645705
Provider Name (Legal Business Name): DANA MARIE DOBER D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 10/08/2021
Certification Date: 10/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 REED RD STE B6
BROOMALL PA
19008
US

IV. Provider business mailing address

590 REED RD STE B6
BROOMALL PA
19008-3654
US

V. Phone/Fax

Practice location:
  • Phone: 484-472-6726
  • Fax: 484-841-2800
Mailing address:
  • Phone: 484-472-6726
  • Fax: 484-841-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005971
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: