Healthcare Provider Details

I. General information

NPI: 1538673231
Provider Name (Legal Business Name): ANNE ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE DOMBROWSKI

II. Dates (important events)

Enumeration Date: 11/17/2017
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date: 06/21/2024
Reactivation Date: 07/12/2024

III. Provider practice location address

145 HOSPITAL AVE STE 215
DU BOIS PA
15801-1464
US

IV. Provider business mailing address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-4000
  • Fax: 814-375-4011
Mailing address:
  • Phone: 814-375-6549
  • Fax: 814-372-2864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: