Provider Demographics
NPI:1841381621
Name:LOBERT, PAUL F (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:LOBERT
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 1:1774 PECK STREET
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-2533
Mailing Address - Country:US
Mailing Address - Phone:231-728-5758
Mailing Address - Fax:231-728-5636
Practice Address - Street 1:1774 PECK STREET
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-2533
Practice Address - Country:US
Practice Address - Phone:231-728-5758
Practice Address - Fax:231-728-5636
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301038078207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2099460Medicaid
MI1372593Medicaid
MI2099460Medicaid
MI0F11505Medicare PIN
MI0F16024Medicare PIN