Provider Demographics
NPI:1578771770
Name:SCOBLIC, HELEN (MD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:
Last Name:SCOBLIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9214 LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:PORT AUSTIN
Mailing Address - State:MI
Mailing Address - Zip Code:48467-9234
Mailing Address - Country:US
Mailing Address - Phone:989-738-7365
Mailing Address - Fax:989-738-7365
Practice Address - Street 1:1426 STRAITS DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-8705
Practice Address - Country:US
Practice Address - Phone:989-667-3440
Practice Address - Fax:989-667-3437
Is Sole Proprietor?:No
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHS029829207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11-0-32-41921OtherBLUE CROSS
MI2098293Medicaid
MIB45590Medicare UPIN
MI2098293Medicaid