Provider Demographics
NPI:1033256706
Name:ZOBEL, LARRY RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:RAY
Last Name:ZOBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 VIRGINIA CIR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1347
Mailing Address - Country:US
Mailing Address - Phone:952-944-5744
Mailing Address - Fax:
Practice Address - Street 1:220 6W 08 3M CTR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55144-0001
Practice Address - Country:US
Practice Address - Phone:651-733-5181
Practice Address - Fax:651-733-5152
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251332083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNF66512Medicare UPIN