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Individual

DR. DOUGLAS JAN PRAVDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
9003 SE HAWKS NEST CT, HOBE SOUND, FL 33455-8927
(908) 241-3181
(908) 241-1669
Mailing address
287 WATCHUNG FRK, WESTFIELD, NJ 07090-3816
(908) 233-7383

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MB03272500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10664103
UNIVERSAL CREDENTIALING
NJ
01
127381096
OTHER INSURANCE COMPANIES
NJ
01
US-292
OXFORD INSURANCE
NH
Enumeration date
02/02/2006
Last updated
05/09/2025
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