Provider Demographics
NPI:1194127464
Name:SUBEI, OBADA (MD)
Entity type:Individual
Prefix:
First Name:OBADA
Middle Name:
Last Name:SUBEI
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 1:3877 N 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5084
Mailing Address - Country:US
Mailing Address - Phone:623-777-7716
Mailing Address - Fax:623-806-8650
Practice Address - Street 1:3877 N 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-5084
Practice Address - Country:US
Practice Address - Phone:623-777-7716
Practice Address - Fax:623-806-8650
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64129207W00000X, 207WX0109X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmology