Provider Demographics
NPI:1124086236
Name:LOBEL, MARTIN LEWIS (MD)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:LEWIS
Last Name:LOBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E WISCONSIN AVE
Mailing Address - Street 2:900
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-4300
Mailing Address - Country:US
Mailing Address - Phone:414-271-4204
Mailing Address - Fax:414-271-0373
Practice Address - Street 1:324 E WISCONSIN AVE
Practice Address - Street 2:900
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-4300
Practice Address - Country:US
Practice Address - Phone:414-271-4204
Practice Address - Fax:414-271-0373
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19427207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30109200Medicaid
WI000002624-0003Medicare ID - Type Unspecified
WI30109200Medicaid