Provider Demographics
NPI:1760473094
Name:HASBANY, ROBERT T (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:T
Last Name:HASBANY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:28200 JOHN R RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-2814
Mailing Address - Country:US
Mailing Address - Phone:248-547-1400
Mailing Address - Fax:248-548-7208
Practice Address - Street 1:28200 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2814
Practice Address - Country:US
Practice Address - Phone:248-547-1400
Practice Address - Fax:248-548-7208
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301064166207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIRH064166OtherBCBS
MI1175OtherCAPE
MIC5975OtherMCARE
MI101881OtherGREAT LAKES
MI001172OtherMIDWEST
MI102776OtherGREAT LAKES HEALTH PLAN
MI114153812Medicaid
MI6719372OtherCIGNA
0806332922OtherBLUE CROSS BLUE SHIELD
91599OtherAETNA
MI221205OtherSELECTCARE
MI102776OtherGREAT LAKES HEALTH PLAN
91599OtherAETNA
MI101881OtherGREAT LAKES
MI0M92460011Medicare PIN