Individual
MARY LEE TOBIN-ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
610 S LINCOLN RD, ESCANABA, MI 49829-1215
(906) 786-6488
(906) 786-6409
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301084091
MI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
4301084091
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0805211002
BLUE CROSS BLUE SHIELD MI
MI
05
—
5200345
—
MI
Enumeration date
04/18/2007
Last updated
10/25/2023
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