Provider Demographics
NPI:1982735908
Name:HABICHT, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:HABICHT
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 1:1734 YORK RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5606
Mailing Address - Country:US
Mailing Address - Phone:410-252-2273
Mailing Address - Fax:443-275-5225
Practice Address - Street 1:1734 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5606
Practice Address - Country:US
Practice Address - Phone:410-252-2273
Practice Address - Fax:443-275-5225
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD67219208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD414669700Medicaid
MD935906-01OtherCAREFIRST BC/BS
MDS062-0330OtherCAREFIRST BC/BS REGIONAL
MD414669700Medicaid
MD126742Y1PMedicare PIN