Provider Demographics
NPI:1255321683
Name:FOLBE, MITCHELL HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:HOWARD
Last Name:FOLBE
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 1:115 E LONG LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5524
Mailing Address - Country:US
Mailing Address - Phone:248-879-2500
Mailing Address - Fax:248-879-2997
Practice Address - Street 1:115 E LONG LAKE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-5524
Practice Address - Country:US
Practice Address - Phone:248-879-2500
Practice Address - Fax:248-879-2997
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059575207RH0003X
MIMF059575207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
110F302150OtherBC
383355345OtherPPOM
900002413OtherPALMETTO GBA
C7809OtherMCARE
G55167OtherALLIANCE HEALTH
P94244OtherBCN MEDICAL ONE