Healthcare Provider Details
I. General information
NPI: 1194707489
Provider Name (Legal Business Name): ARTHUR JOEL SOBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2005
Last Update Date: 07/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 STANIFORD ST SUITE 200
BOSTON MA
02114-2517
US
IV. Provider business mailing address
PO BOX 9142
CHARLESTOWN MA
02129-9142
US
V. Phone/Fax
- Phone: 617-726-2914
- Fax: 617-724-2135
- Phone: 617-726-2914
- Fax: 617-726-7768
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | 34825 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 34825 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: