Individual
DR. DORIS V PABLO-BUSTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1140 VARNUM ST NE PMB 202, WASHINGTON, DC 20017-2151
(202) 269-6430
(202) 269-6598
Mailing address
1140 VARNUM ST NE PMB 202, WASHINGTON, DC 20017-2151
(202) 269-6430
(202) 269-6598
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD30307
DC
261QP2300X
Primary Care Clinic/Center
0101056019
VA
261QP2300X
Primary Care Clinic/Center
MD30307
DC
302F00000X
Exclusive Provider Organization
0101056019
VA
302F00000X
Exclusive Provider Organization
D0058776
MD
302F00000X
Exclusive Provider Organization
MD30307
DC
302R00000X
Health Maintenance Organization
0101056019
VA
302R00000X
Health Maintenance Organization
D0058776
MD
302R00000X
Health Maintenance Organization
MD30307
DC
305R00000X
Preferred Provider Organization
0101056019
VA
305R00000X
Preferred Provider Organization
D0058776
MD
305R00000X
Preferred Provider Organization
MD30307
DC
305S00000X
Point of Service
0101056019
VA
305S00000X
Point of Service
D0058776
MD
305S00000X
Point of Service
MD30307
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033872900
—
DC
05
—
050883700
—
DC
05
—
510223500
—
MD
01
—
F811-0001
CAREFIRST BCBS
VA
Enumeration date
09/05/2006
Last updated
10/11/2024
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