Provider Demographics
NPI:1831271162
Name:DOBOS, MICHAEL JOSPEH JR (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSPEH
Last Name:DOBOS
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27020 CEDAR RD APT 207
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1136
Mailing Address - Country:US
Mailing Address - Phone:440-357-6740
Mailing Address - Fax:
Practice Address - Street 1:7 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3210
Practice Address - Country:US
Practice Address - Phone:440-357-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5547/T2461152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist