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NPI Code Detail

MEDICARE: DR. MICHAEL ROBERT SOBOCINSKI PHD

MEDICARE: DR. MICHAEL ROBERT SOBOCINSKI PHD
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
1103TC2200XClinical Child & Adolescent Psychologist527AK

General Provider Information

NPI Number : 1912172404
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ROBERT SOBOCINSKI PHD
Provider Business Mailing Address
First Line : 4600 ABBOTT RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-4314
Country : US
Telephone Number : 907-348-9295
Fax Number : 907-348-9230
Provider Business Practice Location Address
First Line : 4600 ABBOTT RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-4314
Country : US
Telephone Number : 907-348-9295
Fax Number : 907-348-9230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2008
Last Update Date : 04/25/2008

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