Provider Demographics
NPI:1427365196
Name:TOBBE, DOUGLAS JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:JOHN
Last Name:TOBBE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20401 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1999
Mailing Address - Country:US
Mailing Address - Phone:248-449-5733
Mailing Address - Fax:248-449-5765
Practice Address - Street 1:20401 HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-1999
Practice Address - Country:US
Practice Address - Phone:248-449-5733
Practice Address - Fax:248-449-5765
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist