Provider Demographics
NPI:1033265236
Name:NOBLE, MAUREEN SALOPEK (MD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:SALOPEK
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAUREEN
Other - Middle Name:PATRICE
Other - Last Name:SALOPEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1040 S WINTER ST
Mailing Address - Street 2:SUITE 1022
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-3876
Mailing Address - Country:US
Mailing Address - Phone:734-646-9117
Mailing Address - Fax:
Practice Address - Street 1:1040 S WINTER ST
Practice Address - Street 2:SUITE 1022
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-3876
Practice Address - Country:US
Practice Address - Phone:517-263-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2010-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010729942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4150300Medicaid