Provider Demographics
NPI:1861449696
Name:MAHABEER, HOWARD L (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:L
Last Name:MAHABEER
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 1:4150 225TH AVE
Mailing Address - Street 2:
Mailing Address - City:REED CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49677-7918
Mailing Address - Country:US
Mailing Address - Phone:231-832-3930
Mailing Address - Fax:231-832-2456
Practice Address - Street 1:4150 225TH AVE
Practice Address - Street 2:
Practice Address - City:REED CITY
Practice Address - State:MI
Practice Address - Zip Code:49677-7918
Practice Address - Country:US
Practice Address - Phone:231-832-3930
Practice Address - Fax:231-832-2456
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048268207Q00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2622761Medicaid
MI2622761Medicaid
MI0P09930Medicare ID - Type Unspecified