Provider Demographics
NPI:1164261699
Name:DUBIL, MATT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATT
Middle Name:
Last Name:DUBIL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 CHAMBERS RD APT 205B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1723
Mailing Address - Country:US
Mailing Address - Phone:440-596-7363
Mailing Address - Fax:
Practice Address - Street 1:60 WORTHINGTON MALL
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-5206
Practice Address - Country:US
Practice Address - Phone:614-410-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy