Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD062010L | PA |
N | 207YP0228X | Pediatric Otolaryngology | MD062010L | PA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD062010L | PA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD062010L | PA |
NPI | 1518051036 |
---|---|
Provider Name | Dr. Bret T. Sobota |
First Address | Gettysburg, PA 17325-2594 |
Second Address | Gettysburg, PA 17325-2594 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 11/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1007307260034 | MEDICAID GROUP # (01) | PA |
1018454060001 | (05) | PA |
120420405 | DEPT OF LABOR (01) | PA |
1367953 | HIGHMARK BLUESHIELD (01) | PA |
1547181 | GATEWAY (01) | PA |
2163302 | MAMSI (01) | PA |
25-1716306 | DEVON (01) | PA |
25-1716306 | FIRST HEALTH (01) | PA |
25-1716306 | GREATWEST HEALTHCARE (01) | PA |
25-1716306 | HEALTHNET/TRICARE (01) | PA |
25-1716306 | INFORMED (01) | PA |
25-1716306 | INTERGROUP (01) | PA |
25-1716306 | MULTIPLAN/PHCS (01) | PA |
25-1716306 | SOUTH CENTRAL PREFERRED (01) | PA |
3830436 | AETNA HMO (01) | PA |
50066685 | CAPITAL BLUECROSS (01) | PA |
560617 | HEALTH AMERICA (01) | PA |
7064055 | AETNA NON-HMO (01) | PA |
867633 | MEDICARE GROUP # (01) | PA |
BS5623548 | DEA (01) | PA |
G920-0054 | CAREFIRST (01) | PA |
G94805 | (02) | PA |
MD062010L | PA LICENSE (01) | PA |
P00411722 | RAILROAD MEDICARE (01) | PA |