MEDICARE: DR. DAVID BARRY DOLBERG D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	0104000354	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004286516	OTHER		AETNA PPO
2	505363	OTHER		NCPPO
3	849534	OTHER		FOCUS
4	2194700	OTHER		AETNA HMO
5	460103	OTHER		ASHN (AMER SPEC HEALTH NE
6	5511403	OTHER		PHCS (PRIVATE HEALTHCARE
7	428735	OTHER		M.D. IPA HEALTH PLAN
8	428735	OTHER		OPTIMUM CHOICE, INC.
9	460146	OTHER		ACN GROUP, INC.
10	23938011	OTHER		UNITED HEALTHCARE
11	2989101001	OTHER		CIGNA HMO
12	428735	OTHER		ONE NET PPO
13	113695	OTHER		KAISER PERMANENTE
14	428735	OTHER		MAMSI LIFE & HEALTH INS C
15	119987	OTHER	VA	ANTHEM BCBS
16	9650540-001	OTHER		CIGNA PPO
17	P-11117130	OTHER		MULTIPLAN, INC.
18	H838-0001	OTHER		CARE FIRST BCBS

General Provider Information

NPI Number	:	1275678963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID BARRY DOLBERG D.C.

Provider Business Mailing Address
First Line	:	8440 OLD KEENE MILL RD
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-2302
Country	:	US
Telephone Number	:	703-569-1300
Fax Number	:	703-569-1972

Provider Business Practice Location Address
First Line	:	8440 OLD KEENE MILL RD
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-2302
Country	:	US
Telephone Number	:	703-569-1300
Fax Number	:	703-569-1972

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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