Provider Demographics
NPI:1144390857
Name:LOBIS, IRA F (MD, FACP,FACG)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:F
Last Name:LOBIS
Suffix:
Gender:M
Credentials:MD, FACP,FACG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-2686
Mailing Address - Country:US
Mailing Address - Phone:610-444-1974
Mailing Address - Fax:
Practice Address - Street 1:4745 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2067
Practice Address - Country:US
Practice Address - Phone:302-738-5300
Practice Address - Fax:302-731-4822
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0000898174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000106901Medicaid
DE000106901Medicaid
B66504Medicare UPIN