Healthcare Provider Details

I. General information

NPI: 1144390857
Provider Name (Legal Business Name): IRA F LOBIS MD, F.A.C.P.,F.A.C.G
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4745 OGLETOWN STANTON RD
NEWARK DE
19713-2067
US

IV. Provider business mailing address

303 E BRANCH DR
KENNETT SQUARE PA
19348-2686
US

V. Phone/Fax

Practice location:
  • Phone: 302-738-5300
  • Fax: 302-731-4822
Mailing address:
  • Phone: 610-444-1974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC1-0000898
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: