Basic Information
Provider Information
NPI: 1013045939
EntityType: 2
ReplacementNPI:  
OrganizationName: PHILIP D. BOBROW MD PA
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5530 WISCONSIN AVE
Address2: SUITE 1660
City: CHEVY CHASE
State: MD
PostalCode: 208154404
CountryCode: US
TelephoneNumber: 3016579876
FaxNumber: 3019835059
Practice Location
Address1: 5530 WISCONSIN AVE
Address2: SUITE 1660
City: CHEVY CHASE
State: MD
PostalCode: 208154404
CountryCode: US
TelephoneNumber: 3016579876
FaxNumber: 3019835059
Other Information
ProviderEnumerationDate: 03/01/2007
LastUpdateDate: 01/24/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BOBROW
AuthorizedOfficialFirstName: PHILIP
AuthorizedOfficialMiddleName: DAVID
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3016579876
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


Home