Provider Demographics
NPI:1538273412
Name:HABER, MICHELE ANN (MD, MS, MPH)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:ANN
Last Name:HABER
Suffix:
Gender:F
Credentials:MD, MS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4529
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27404-4529
Mailing Address - Country:US
Mailing Address - Phone:336-292-7622
Mailing Address - Fax:336-294-1229
Practice Address - Street 1:1104 N HOLDEN RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-4828
Practice Address - Country:US
Practice Address - Phone:336-292-7622
Practice Address - Fax:336-294-1229
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900522207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F79854Medicare UPIN