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General NPI Number Information
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NPI Number | 1649248931
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Entity Type | Individual
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Provider Name | GREGORY VICTOR SOBOL MD
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Gender | Male
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 17877 W 14 MILE RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025
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Country | US
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Telephone | 248-644-3920
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Fax | 248-644-2569
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Provider Business Mailing Address
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Address Line | 17877 W 14 MILE RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 074673
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301074673
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License Number State | MI
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