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Individual

JOHN ROHAN LOBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4070 LAKE DR SE, GRAND RAPIDS, MI 49546-8294
(616) 949-4340
(616) 949-4341
Mailing address
1000 EAST PARIS AVE SE STE 230, GRAND RAPIDS, MI 49546-3680
(616) 949-4340
(616) 949-4341

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
01092518A
IN
208800000X
Urology Physician
Primary
4301085171
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1103836793
ANTHEM
IN
05
300090847
IN
01
340D160430
BCBSM
MI
05
4748234
MI
01
P00230448
RAILROAD MEDICARE
Enumeration date
08/30/2006
Last updated
01/21/2025
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