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General NPI Number Information
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NPI Number | 1174519698
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Entity Type | Individual
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Provider Name | EITAN SOBEL MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 160 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4560
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Country | US
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Telephone | 802-775-7111
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Fax | 573-302-2241
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Provider Business Mailing Address
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Address Line | 160 ALLEN ST
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City | RUTLAND
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State | VT
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Zip | 05701-4560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2005018610
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 042-0011633
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License Number State | VT
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