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General NPI Number Information
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NPI Number | 1902805013
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Entity Type | Individual
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Provider Name | MITCHELL BOBER DO
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 181 N BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1550
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Country | US
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Telephone | 856-678-9002
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Fax | 856-678-4027
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Provider Business Mailing Address
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Address Line | 181 N BROADWAY
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City | PENNSVILLE
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State | NJ
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Zip | 08070-1550
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Country | US
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Telephone | 856-678-9002
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Fax | 856-678-4027
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB044548
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License Number State | NJ
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