Organization
POTOMAC PODIATRY ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME LOUIS DOVBERG DPM (PRESIDENT/CEO)
(703) 370-5533
Entity
Organization
Contact information
Practice address
15700 CHAPMAN PL, MONTCLAIR, VA 22025-1315
(703) 370-5533
(703) 680-9579
Mailing address
15700 CHAPMAN PL, MONTCLAIR, VA 22025-1315
(703) 370-5533
(703) 680-9579
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000339
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09301127
—
VA
Enumeration date
11/28/2007
Last updated
05/17/2013
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