Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5101016232 | MI |
N | 111NI0900X | Internist | 5101016232 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 5101016232 | MI |
Y | 207RI0011X | Interventional Cardiology | 5101016232 | MI |
N | 2086S0129X | Vascular Surgeon | 5101016232 | MI |
NPI | 1003030685 |
---|---|
Provider Name | Dr. Mohamad A Sobh |
First Address | Dearborn, MI 48124-2912 |
Second Address | Dearborn, MI 48124-2912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 16/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003030685 | (05) | MI |