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NPI Code Detail

MEDICARE: MS. ANDREA MARY MOBILIO MD

MEDICARE: MS. ANDREA MARY MOBILIO 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
12084P0800XPsychiatry Physician4301080412MI
22084P0804XChild & Adolescent Psychiatry Physician4301080412MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1750910468OTHERMIBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982724837
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANDREA MARY MOBILIO MD
Provider Business Mailing Address
First Line : 555 TOWNER ST
Second Line : PO BOX 915
City : YPSILANTI
State : MI
Zip : 48198-5752
Country : US
Telephone Number : 734-544-3000
Fax Number : 734-544-6732
Provider Business Practice Location Address
First Line : 4125 WASHTENAW AVE
Second Line : ANN ARBOR
City : ANN ARBOR
State : MI
Zip : 48108-1003
Country : US
Telephone Number : 734-973-4343
Fax Number : 734-973-4484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2007
Last Update Date : 03/19/2012

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1528332418 — MR. DERRICK L PADGETT LMSW
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1598100026 — NORMA GARCIA LLMSW
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