Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 01011236061 | VA |
NPI | 1437102621 |
---|---|
Provider Name | Dr. Matthew A Dobzyniak |
First Address | Richmond, VA 23255-1690 |
Second Address | Richmond, VA 23226-2553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 15/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010074096 | (05) | VA |
173232 | ANTHEM (01) | VA |
H43439 | (02) |