Healthcare Provider Details

I. General information

NPI: 1780909671
Provider Name (Legal Business Name): CHRISTA HABELA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST CMSC 2-124
BALTIMORE MD
21287-3224
US

IV. Provider business mailing address

1620 13TH PL S
BIRMINGHAM AL
35205-6604
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-6553
  • Fax:
Mailing address:
  • Phone: 205-746-0009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6809
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: