Healthcare Provider Details

I. General information

NPI: 1295477024
Provider Name (Legal Business Name): MITCHELL BOBCEAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2022
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 MAIN ST
MARLETTE MI
48453-1141
US

IV. Provider business mailing address

2770 MAIN ST
MARLETTE MI
48453-1141
US

V. Phone/Fax

Practice location:
  • Phone: 989-635-4000
  • Fax:
Mailing address:
  • Phone: 989-635-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101028545
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: