Provider Demographics
NPI:1609829407
Name:NOBLE, D E (MD PA)
Entity Type:Individual
Prefix:DR
First Name:D
Middle Name:E
Last Name:NOBLE
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:509 SE RIVERSIDE DR
Mailing Address - Street 2:202
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2579
Mailing Address - Country:US
Mailing Address - Phone:772-287-9177
Mailing Address - Fax:772-223-9823
Practice Address - Street 1:509 SE RIVERSIDE DR
Practice Address - Street 2:202
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2579
Practice Address - Country:US
Practice Address - Phone:772-287-9177
Practice Address - Fax:772-223-9823
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL22477207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63021Medicare UPIN
FL93816Medicare ID - Type Unspecified