Karen F. Dubosky, MD
Individual provider Active NPI Pediatrics Physician · Providence Forge, VA
NPI 1679651285 · NPPES record last updated Dec 1, 2008
Key facts
- NPI
- 1679651285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- G47165 (CA)
- Practice address
- 11450 Brickshire Park
Providence Forge, VA 23140-4415 - Phone
- (804) 557-3548
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G47165 | CA | MD | Pediatrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G47165 | CA | Yes |
Addresses
Primary practice location
11450 Brickshire Park
Providence Forge, VA 23140-4415
Mailing address
11450 Brickshire Park
Providence Forge, VA 23140-4415
Phone (804) 557-3548
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0101244623 | Medicaid | VA | |
| 00G471650 | Medicaid | CA |
Other providers in Providence Forge, VA
- Crossgap Ministries Inc.
- Cybecho Company
- Jacob David
- Steven David
- Wendy Dickerson
- Emily Elizabeth Elliott
- Linda Greaver
- Nicole Halligan
- Kyla Hanzlik
- Andrea Michelle Johnson
All providers in Providence Forge, VA · Pediatrics Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.