Provider Demographics
NPI:1235249301
Name:SOBEL, MICHAEL L (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:SOBEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 YACHT HAVEN GRANDE
Mailing Address - Street 2:SUITE N-104, UNIT # 1068
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:614-205-3451
Mailing Address - Fax:
Practice Address - Street 1:9048 SUGAR EST
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-3634
Practice Address - Country:US
Practice Address - Phone:614-205-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA84380207RN0300X, 207R00000X
KY02410207R00000X
VI3486207RN0300X
OH34005598S207RN0300X
SCDO322207RN0300X
IN02001914A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2344645Medicaid
OH2344645Medicaid
OHH078340Medicare PIN