Healthcare Provider Details

I. General information

NPI: 1922329796
Provider Name (Legal Business Name): ERIC DAVID DOBKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W SPROUL RD
SPRINGFIELD PA
19064-2033
US

IV. Provider business mailing address

PO BOX 8500-6355
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 610-338-8243
  • Fax:
Mailing address:
  • Phone: 610-497-7520
  • Fax: 610-497-7525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMD430158
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: