Provider Demographics
NPI:1316920820
Name:SCHOBERT, CAROL M (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:M
Last Name:SCHOBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3355 DOUGLAS RD
Mailing Address - Street 2:STE. 300
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1781
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 I ST
Practice Address - Street 2:
Practice Address - City:LAPORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-5533
Practice Address - Country:US
Practice Address - Phone:219-324-1700
Practice Address - Fax:219-324-1710
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01029403A207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100163790Medicaid
IN100163790Medicaid
IN565800DMedicare PIN