Provider Demographics
NPI:1598794992
Name:DOBMEIER, MICHAEL E (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:DOBMEIER
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 1:425 TITUS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3532
Mailing Address - Country:US
Mailing Address - Phone:585-266-8890
Mailing Address - Fax:585-342-9566
Practice Address - Street 1:425 TITUS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3532
Practice Address - Country:US
Practice Address - Phone:585-266-8890
Practice Address - Fax:585-342-9566
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125483207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY125483-8OtherWORKERS' COMPENSATION
NY0803OtherBLUE SHIELD
NY000921241001OtherHEALTHNOW
NY100730BJOtherPREFERRED CARE
NYP010125483OtherEXCELLUS BLUE CHOICE
NY16693BMedicare ID - Type Unspecified
NY125483-8OtherWORKERS' COMPENSATION