Provider Demographics
NPI:1780650143
Name:MIHALEY-SOBELMAN, DEBORA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:ANN
Last Name:MIHALEY-SOBELMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORA
Other - Middle Name:ANN
Other - Last Name:MIHALEY-SOBELMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2001 RIVERMONT AVE APT 105
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-4110
Mailing Address - Country:US
Mailing Address - Phone:860-836-1551
Mailing Address - Fax:
Practice Address - Street 1:2010 ATHERHOLT RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1106
Practice Address - Country:US
Practice Address - Phone:434-200-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPENDING207QH0002X
CT037402208000000X
VA0101269171207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004236007Medicaid
CT370001696Medicare ID - Type Unspecified
CTD87913Medicare UPIN