Provider Demographics
NPI:1881200434
Name:WOBSER, MICHAEL ANGELO
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:WOBSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4202 WHISPERING PINES LN
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-7086
Mailing Address - Country:US
Mailing Address - Phone:419-357-2208
Mailing Address - Fax:
Practice Address - Street 1:4202 WHISPERING PINES LN
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-7086
Practice Address - Country:US
Practice Address - Phone:419-357-2208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant