Individual
DR. BOHDAN WSEWOLOD DOBERCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7900 OLD YORK RD, APARTMENT 105A, ELKINS PARK, PA 19027-2318
(215) 224-3330
(215) 641-9987
Mailing address
7900 OLD YORK RD, APARTMENT 105A, ELKINS PARK, PA 19027-2318
(215) 224-3330
(215) 641-9987
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
MD020681E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046255000
PERSONAL CHOICE
PA
01
—
11559069
CAQH
PA
01
—
P00050626
RAILROAD MEDICARE
PA
Enumeration date
10/29/2006
Last updated
07/09/2007
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