Provider Demographics
NPI:1427002252
Name:SOBEL, RICHARD M (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:SOBEL
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 1:101 PASSAGE PT
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3295
Mailing Address - Country:US
Mailing Address - Phone:404-723-2721
Mailing Address - Fax:770-486-8838
Practice Address - Street 1:101 PASSAGE PT
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3295
Practice Address - Country:US
Practice Address - Phone:404-723-2721
Practice Address - Fax:770-486-8838
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082156S207P00000X
GA24100207P00000X
FL45942207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000316964OtherBCBS
OH2418075Medicaid
OH2418075Medicaid
000000316964OtherBCBS