Provider Demographics
NPI:1215069497
Name:SOBCHUK, PAUL A (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:SOBCHUK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2843
Mailing Address - Country:US
Mailing Address - Phone:207-594-2208
Mailing Address - Fax:
Practice Address - Street 1:99 PARK ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2843
Practice Address - Country:US
Practice Address - Phone:207-594-2208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS403103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME703912Medicare ID - Type Unspecified