Individual
DEXTER DOROMAL JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
609 W GERMANTOWN PIKE STE 120, EAST NORRITON, PA 19403-4243
(610) 279-1370
(610) 279-1372
Mailing address
207 N BROAD ST FL 3, PHILADELPHIA, PA 19107-1500
(610) 279-1370
(610) 279-1372
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD459805
PA
207RI0011X
Interventional Cardiology Physician
Primary
MD459805
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037689880003
—
PA
Enumeration date
03/30/2012
Last updated
07/10/2023
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