Provider Demographics
NPI:1346233160
Name:HABER, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:HABER
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 1:26949 CHAGRIN BLVD
Mailing Address - Street 2:#300
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4278
Mailing Address - Country:US
Mailing Address - Phone:216-932-5200
Mailing Address - Fax:216-932-5212
Practice Address - Street 1:26949 CHAGRIN BLVD
Practice Address - Street 2:#300
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4278
Practice Address - Country:US
Practice Address - Phone:216-932-5200
Practice Address - Fax:216-932-5212
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064474207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0123182Medicaid
OH0123182Medicaid
OH0772446Medicare PIN