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Individual

KENNETH J DOBULER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-7573
(203) 732-7418
Mailing address
130 DIVISION ST, DERBY, CT 06418
(203) 732-7573
(203) 732-7418

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
019661
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00119661700
CT
Enumeration date
07/04/2006
Last updated
07/08/2007
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