Dudik Bross, Jill A
Dudik Bross, Jill A is an individual health care provider with primary practice located at 615 S Division St , Moses Lake WA 98837-3800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dudik Bross, Jill A can be contacted via phone (509) 766-9450.Contact Information
Primary practice address
615 S Division St
Moses Lake WA 98837-3800
Phone: (509) 766-9450
Fax: (509) 766-1954
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00025968 | Washington |
Profile Details
| NPI number | 1205837242 |
|---|---|
| LBN Legal business name | Dudik Bross, Jill A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 1st, 2005 |
| Last updated | Mar 29th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205837242 | NPPES |
| Washington | MEDICAID | 1102730 |
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