MEDICARE: DR. MICHAEL CHARLES MOBLEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	19470	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386626646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL CHARLES MOBLEY M.D.

Provider Business Mailing Address
First Line	:	4849 PAULSEN ST
Second Line	:	SUITE 201
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4423
Country	:	US
Telephone Number	:	912-354-8108
Fax Number	:	912-354-0139

Provider Business Practice Location Address
First Line	:	4849 PAULSEN ST
Second Line	:	SUITE 201
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4423
Country	:	US
Telephone Number	:	912-354-8108
Fax Number	:	912-354-0139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	07/08/2007

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