Individual
JOHN A SOBOLEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2490 CENTRAL AVE, LAKE STATION, IN 46405-2122
(219) 763-8112
(219) 764-3251
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-3251
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01036528A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200106540
—
IN
Enumeration date
09/19/2005
Last updated
01/25/2018
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