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General NPI Number Information
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NPI Number | 1831185404
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Entity Type | Individual
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Provider Name | ESTHER A SOBONG MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2990 FRANKLIN AVE SW
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City | GRANDVILLE
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State | MI
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Zip | 49418-3505
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Country | US
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Telephone | 616-530-3344
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Fax | 616-532-8040
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Provider Business Mailing Address
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Address Line | PO BOX 936
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City | GRANDVILLE
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State | MI
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Zip | 49468-0936
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Country | US
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Telephone | 616-530-3344
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Fax | 616-532-8040
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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 | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 4301038512
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License Number State | MI
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