Provider Demographics
NPI:1558365817
Name:BOBISH, KRISTINE E (DO)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:E
Last Name:BOBISH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:101E MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-1460
Mailing Address - Country:US
Mailing Address - Phone:989-448-7002
Mailing Address - Fax:989-448-2999
Practice Address - Street 1:101E MITCHELL ST
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1460
Practice Address - Country:US
Practice Address - Phone:989-448-7002
Practice Address - Fax:989-448-2999
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101014831207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1558365817OtherNPI #
MIKB014831OtherBCBSM
MI4829557-11Medicaid
MI70-0-F32947-0OtherBCBS CPIN #
MIP61990011Medicare PIN
MI1558365817OtherNPI #