Healthcare Provider Details

I. General information

NPI: 1750590931
Provider Name (Legal Business Name): CHRISTOPHER EMIL HABERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STATE AVE
PANAMA CITY FL
32405-4587
US

IV. Provider business mailing address

2100 STATE AVE
PANAMA CITY FL
32405-4587
US

V. Phone/Fax

Practice location:
  • Phone: 850-763-0036
  • Fax: 850-763-0259
Mailing address:
  • Phone: 850-763-0036
  • Fax: 850-763-0259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number059653
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number059653
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberME143843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: