Provider Demographics
NPI:1083799977
Name:HABIG, ROBERT D (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:HABIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15229 WESTFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8000
Mailing Address - Country:US
Mailing Address - Phone:317-867-1236
Mailing Address - Fax:317-896-1299
Practice Address - Street 1:15229 WESTFIELD BLVD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8000
Practice Address - Country:US
Practice Address - Phone:317-867-1236
Practice Address - Fax:317-896-1299
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100063270Medicaid
IN100063270Medicaid
IN151560IIIMedicare PIN
IN151560IIIMedicare PIN
IN100063270Medicaid