Provider Demographics
NPI:1811968258
Name:LOBO, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:LOBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3241 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4850
Mailing Address - Country:US
Mailing Address - Phone:203-383-4466
Mailing Address - Fax:203-383-4499
Practice Address - Street 1:3241 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4850
Practice Address - Country:US
Practice Address - Phone:203-383-4466
Practice Address - Fax:203-383-4499
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT038775207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT038775OtherCT CARE
CT213697OtherWELLCARE
CT7728407OtherAETNA
CT001387754OtherFIRST CHOICE
CT0013887754Medicaid
CT010038775CT01OtherBLUE CROSS
CT2V2347OtherHEALTHNET
CT001387754OtherCHN
CT001387754-00OtherBLUECARE FAMILY PLAN
CT061608343OtherCIGNA
CTP2734740OtherOXFORD
CT061608343OtherUNITED HEALTHCARE
CT110245778OtherRAILROAD MEDICARE
CT061608343OtherCIGNA
CT213697OtherWELLCARE