Provider Demographics
NPI:1497735211
Name:HABER, ROBERT F
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:HABER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 N CENTER ST
Mailing Address - Street 2:FOOT HEALTH CENTER OF HICKORY
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3760
Mailing Address - Country:US
Mailing Address - Phone:828-322-1391
Mailing Address - Fax:828-322-1392
Practice Address - Street 1:1208 N CENTER ST
Practice Address - Street 2:FOOT HEALTH CENTER OF HICKORY
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3760
Practice Address - Country:US
Practice Address - Phone:828-322-1391
Practice Address - Fax:828-322-1392
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC246213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08096OtherBLUE CROSS BLUE SHIELD
NC7908096Medicaid
480006138OtherRAILROAD MEDICARE PIN
480006138OtherRAILROAD MEDICARE PIN
NC561577250OtherEIN NUMBER
NC7908096Medicaid