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General NPI Number Information
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NPI Number | 1366837536
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Entity Type | Individual
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Provider Name | MICHAEL DOMBEK MD
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Gender | Male
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 300 MOUNT AUBURN ST STE 407
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5665
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Country | US
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Telephone | 617-868-7456
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Fax | 617-868-9243
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Provider Business Mailing Address
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Address Line | 330 MOUNT AUBURN ST # 2
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City | CAMBRIDGE
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State | MA
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Zip | 02138-5597
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Country | US
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Telephone | 617-499-5083
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 274707
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 274707
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License Number State | MA
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