Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 0101245151 | VA |
NPI | 1306058201 |
---|---|
Provider Name | Eric J Dobratz |
First Address | Norfolk, VA 23501-0936 |
Second Address | Norfolk, VA 23507-1904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 12/04/2019 |