MEDICARE: DR. CYNTHIA CAROL MOBLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D0040332	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184745374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA CAROL MOBLEY MD

Provider Business Mailing Address
First Line	:	3601 CROSSLAND AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21213-1006
Country	:	US
Telephone Number	:	410-889-0884
Fax Number	:	410-669-0071

Provider Business Practice Location Address
First Line	:	1374 W NORTH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21217-3536
Country	:	US
Telephone Number	:	410-396-0063
Fax Number	:	410-669-0071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/09/2007

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