Provider Demographics
NPI:1407967284
Name:SOBOLEWSKI, ERIKA L (DO)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:L
Last Name:SOBOLEWSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 MASSILLON RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6400
Mailing Address - Country:US
Mailing Address - Phone:330-899-9350
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:62 CONSERVATORY DR
Practice Address - Street 2:SUITE B
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-9002
Practice Address - Country:US
Practice Address - Phone:330-753-2400
Practice Address - Fax:330-634-1329
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-7142-S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSO4045581OtherMEDICARE ID
OH4045583OtherMEDICARE ID
OH2253029Medicaid
OH4045583OtherMEDICARE ID