DR. KENNETH E. VOBACH MD NPI 1174511125

NPI Information

NPI: 1174511125
Provider Name: DR. KENNETH E. VOBACH, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 23D2254331

Address:
110 EAST THIRD STREET
DAVISON, MI
ZIP 48423
Phone: (810) 412-5437
Get Directions

DR. Kenneth E. Vobach, MD is a pediatrics in Davison, MI. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Kenneth E. Vobach, MD NPI is 1174511125. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

110 EAST THIRD STREET
DAVISON, MI
ZIP 48423
Phone: (810) 412-5437
Fax: (810) 412-5448

The CLIA number assigned to this NPI record is 23D2254331 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/12/2005 and was last updated on 11/8/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		4301075399	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0M28420016	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
2	4206451	MEDICAID	MICHIGAN
3	253067	OTHER	MICHIGAN	MCLAREN HEALTH PLAN
4	350D410030	OTHER	MICHIGAN	BLUE CARE NETWORK
5	4475609	OTHER	MICHIGAN	AETNA
6	3502505081	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD
7	C7478	OTHER	MICHIGAN	MCARE
8	F78643	OTHER	MICHIGAN	HEATLH NET FEDERAL SERV
9	F78643	MEDICARE UPIN	MICHIGAN
10	253067	OTHER	MICHIGAN	HEALTH ADVANTAGE NETWORK
11	350D410030	OTHER	MICHIGAN	BLUE CROSS BLUE SHIELD
12	370018374	OTHER	MASSACHUSETTS	METRAHEALTH
13	6824734009	OTHER	MICHIGAN	CIGNA
14	F78643	OTHER	MICHIGAN	HEALTH ALLIANCE PLAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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