Provider Demographics
NPI:1932846755
Name:TOBIN, KEVIN G
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:G
Last Name:TOBIN
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 1:4919 MURRAYHILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-2314
Mailing Address - Country:US
Mailing Address - Phone:443-890-0158
Mailing Address - Fax:
Practice Address - Street 1:185 ADMIRAL COCHRANE DR STE 120
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7600
Practice Address - Country:US
Practice Address - Phone:443-440-5780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)