Provider Demographics
NPI:1598899569
Name:SOBEL, SCOTT DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:SOBEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9603 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4129
Mailing Address - Country:US
Mailing Address - Phone:410-902-0056
Mailing Address - Fax:410-902-0059
Practice Address - Street 1:9603 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4129
Practice Address - Country:US
Practice Address - Phone:410-902-0056
Practice Address - Fax:410-902-0059
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01758111NR0200X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111NR0200XChiropractic ProvidersChiropractorRadiology
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU61821Medicare UPIN