Provider Demographics
NPI:1386626646
Name:MOBLEY, MICHAEL CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHARLES
Last Name:MOBLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4849 PAULSEN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4423
Mailing Address - Country:US
Mailing Address - Phone:912-354-8108
Mailing Address - Fax:912-354-0139
Practice Address - Street 1:4849 PAULSEN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4423
Practice Address - Country:US
Practice Address - Phone:912-354-8108
Practice Address - Fax:912-354-0139
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA194702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00153832BMedicaid
GA00153832BMedicaid