Provider Demographics
NPI:1790801900
Name:HABERMAN, MICHAEL ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:HABERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1050 CROWN POINTE PKWY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-7707
Mailing Address - Country:US
Mailing Address - Phone:770-551-2772
Mailing Address - Fax:770-551-2779
Practice Address - Street 1:1050 CROWN POINTE PKWY
Practice Address - Street 2:SUITE 360
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-7707
Practice Address - Country:US
Practice Address - Phone:770-551-2772
Practice Address - Fax:770-551-2779
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0166072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD29648Medicare UPIN