Healthcare Provider Details

I. General information

NPI: 1982735908
Provider Name (Legal Business Name): ROBERT J HABICHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1734 YORK RD
LUTHERVILLE MD
21093-5606
US

IV. Provider business mailing address

1734 YORK RD
LUTHERVILLE MD
21093-5606
US

V. Phone/Fax

Practice location:
  • Phone: 410-252-2273
  • Fax: 443-275-5225
Mailing address:
  • Phone: 410-252-2273
  • Fax: 443-275-5225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD67219
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD67219
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: