Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 246 | NC |
N | 213ES0131X | Foot Surgery | 246 | NC |
NPI | 1497735211 |
---|---|
Provider Name | Robert F Haber |
First Address | Hickory, NC 28601-3760 |
Second Address | Hickory, NC 28601-3760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 23/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08096 | BLUE CROSS BLUE SHIELD (01) | NC |
480006138 | RAILROAD MEDICARE PIN (01) | |
7908096 | (05) | NC |
T64084 | (02) |