Provider Demographics
NPI:1255336673
Name:HABER, CRAIG G (MD)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:G
Last Name:HABER
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 1:106 BUSINESS CENTER DR # DT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-1229
Mailing Address - Country:US
Mailing Address - Phone:410-848-8202
Mailing Address - Fax:410-848-2644
Practice Address - Street 1:106 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:410-848-8202
Practice Address - Fax:410-848-2644
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD24866174400000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD522208116OtherCOMMERCIAL
MD328831500Medicaid
MD875504OtherUNITED HEALTHCARE (P)
MD0C60CG35120202OtherBC MD
MD375504OtherUNITED HEALTHCARE(S)
DCR8870001OtherBC DC/METRO
MD110199837OtherMEDICARE RAILROAD
MD328831500Medicaid
MD0C60CG35120202OtherBC MD
MD522208116OtherCOMMERCIAL