Provider Demographics
NPI:1639100043
Name:SOBEL, ADAM CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:CRAIG
Last Name:SOBEL
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 1:306 E LANCASTER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2105
Mailing Address - Country:US
Mailing Address - Phone:484-476-7255
Mailing Address - Fax:484-476-7854
Practice Address - Street 1:306 E LANCASTER AVE STE 300
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2105
Practice Address - Country:US
Practice Address - Phone:484-476-7255
Practice Address - Fax:484-476-7854
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053607L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA729421Medicare PIN
PAG22736Medicare UPIN
PA0077805940001Medicaid