Provider Demographics
NPI:1275582934
Name:LOBIS, MICHAEL R (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:R
Last Name:LOBIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2000 FOULK ROAD
Mailing Address - Street 2:SUITE F
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:302-652-8990
Mailing Address - Fax:302-652-8646
Practice Address - Street 1:2000 FOULK ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:302-652-8990
Practice Address - Fax:302-652-8646
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0004778208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000798301Medicaid
863156B97Medicare ID - Type Unspecified
DE0000798301Medicaid