Provider Demographics
NPI:1871962670
Name:M&D SPECIALTY SERVICES PA
Entity type:Organization
Organization Name:M&D SPECIALTY SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DULEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-387-6248
Mailing Address - Street 1:P.O. BOX 50870
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76206
Mailing Address - Country:US
Mailing Address - Phone:940-387-6248
Mailing Address - Fax:940-381-1881
Practice Address - Street 1:3321 UNICORN LAKE BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:940-387-6248
Practice Address - Fax:940-381-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty