Individual
JENNIFER L SOBOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2300 HAGGERTY RD, SUITE 2000, WEST BLOOMFIELD, MI 48323-2184
(248) 624-9900
(248) 896-5450
Mailing address
20952 E 12 MILE RD, SUITE 200, ST CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5101014303
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01004413
HEALTH PLUS
MI
01
—
141750
PRIORITY HEALTH
MI
01
—
3638013
CIGNA
MI
01
—
7752690
AETNA
MI
01
—
I31997
HAP
MI
01
—
P00392201
RAILROAD MEDICARE
MI
Enumeration date
04/19/2006
Last updated
07/28/2008
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