Provider Demographics
NPI:1982724837
Name:MOBILIO, ANDREA MARY (MD)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:MARY
Last Name:MOBILIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:555 TOWNER ST
Mailing Address - Street 2:PO BOX 915
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5752
Mailing Address - Country:US
Mailing Address - Phone:734-544-3000
Mailing Address - Fax:734-544-6732
Practice Address - Street 1:4125 WASHTENAW AVE
Practice Address - Street 2:ANN ARBOR
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1003
Practice Address - Country:US
Practice Address - Phone:734-973-4343
Practice Address - Fax:734-973-4484
Is Sole Proprietor?:No
Enumeration Date:2007-03-31
Last Update Date:2012-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010804122084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI750910468OtherBLUE CROSS
MI5304519Medicaid
MI0H16014105Medicare PIN