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General NPI Number Information
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NPI Number | 1215151451
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Entity Type | Organization
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Legal Business Name | GREGORY M DOWBAK MD PA
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 27399 RIVERVIEW CENTER BLVD 101
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-4303
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Country | US
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Telephone | 239-498-4910
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Fax |
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Provider Business Mailing Address
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Address Line | 285 GRANDE WAY
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City | NAPLES
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State | FL
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Zip | 34110-6424
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Country | US
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Telephone | 239-218-3428
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. GREGORY M DOWBAK
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Credential | M.D.
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Telephone | 239-498-4910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 43416
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License Number State | FL
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