Provider Demographics
NPI:1932289618
Name:MITCHELL FOLBE M D P C
Entity Type:Organization
Organization Name:MITCHELL FOLBE M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-879-2500
Mailing Address - Street 1:115 E LONG LK RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085
Mailing Address - Country:US
Mailing Address - Phone:248-879-2500
Mailing Address - Fax:248-813-6511
Practice Address - Street 1:115 E LONG LK RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085
Practice Address - Country:US
Practice Address - Phone:248-879-2500
Practice Address - Fax:248-813-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMF059575207RH0003X
MILT072320207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF30215OtherBCBSM
MION7730Medicare ID - Type Unspecified