Provider Demographics
NPI:1053352104
Name:SOBEL, PAUL JOSEPH (MA)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:JOSEPH
Last Name:SOBEL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:P
Other - Middle Name:JOSEPH
Other - Last Name:SOBEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:415 W US HIGHWAY 2 STE 2
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49870-1175
Mailing Address - Country:US
Mailing Address - Phone:906-563-7005
Mailing Address - Fax:906-563-5809
Practice Address - Street 1:2626 WINNE AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4917
Practice Address - Country:US
Practice Address - Phone:406-443-8838
Practice Address - Fax:406-443-6367
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501003307237700000X
MI1601000667231H00000X
WI586-156231H00000X
MI7101004159235Z00000X
WI3950-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist