Healthcare Provider Details

I. General information

NPI: 1700808003
Provider Name (Legal Business Name): RICHARD M SOBEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 N PROVIDENCE RD
MEDIA PA
19063-1210
US

IV. Provider business mailing address

5565 N BARRASCA AVE
TUCSON AZ
85750-6495
US

V. Phone/Fax

Practice location:
  • Phone: 215-731-1901
  • Fax: 215-731-9503
Mailing address:
  • Phone: 215-731-1901
  • Fax: 215-731-9503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA11176600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME78289
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number25MA11176600
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberMD035260E
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License NumberME78289
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD035260E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: