Basic Information
| Provider Information | |||||||||
| NPI: | 1942290978 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOBIN | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8745 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049158745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4434816480 | ||||||||
| FaxNumber: | 4434816515 | ||||||||
| Practice Location | |||||||||
| Address1: | 4175 N HANSON CT | ||||||||
| Address2: | 203A | ||||||||
| City: | BOWIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207163179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014649660 | ||||||||
| FaxNumber: | 3014642020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 02/14/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0034403 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 7686388 | 01 | MD | AETNA PPO | OTHER | 52425203 | 01 | MD | BCBS | OTHER | 0735502 | 01 | MD | AETNA HMO | OTHER | 56710001 | 01 | DC | BCBS | OTHER |