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Organization

LEONARD DZUBOW MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEONARD DZUBOW MD (PRESIDENT)
(484) 621-0082
Entity
Organization

Contact information

Practice address
101 CHESLEY DR, MEDIA, PA 19063-1761
(484) 621-0082
(484) 621-0083
Mailing address
101 CHESLEY DR, MEDIA, PA 19063-1761
(484) 621-0082
(484) 621-0083

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1471277
BLUE SHIELD
PA
01
DG8309
MEDICARE RAILROAD
PA
Enumeration date
05/23/2006
Last updated
09/13/2010
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