Provider Demographics
NPI:1497845671
Name:HALEBLIAN, GEORGE E (MD)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:E
Last Name:HALEBLIAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:123 SUMMER ST
Mailing Address - Street 2:STE 210
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608
Mailing Address - Country:US
Mailing Address - Phone:508-368-3183
Mailing Address - Fax:508-368-3193
Practice Address - Street 1:123 SUMMER STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-368-3183
Practice Address - Fax:508-368-3193
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2013-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2005-00198208800000X
RIMD12326208800000X
MA249992208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I36364Medicare UPIN