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General NPI Number Information
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NPI Number | 1467424218
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Entity Type | Individual
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Provider Name | DEBORAH HABENICHT M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 42 NORTH ST.JOSEPH AVE SUITE 300
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City | NILES
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State | MI
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Zip | 49120-2296
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Country | US
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Telephone | 269-687-2910
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Fax | 269-687-8770
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Provider Business Mailing Address
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Address Line | 6416 DEANS HILL ROAD
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49120-9750
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Country | US
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Telephone | 269-471-7741
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Fax | 269-471-1581
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301074195
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301074195
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License Number State | MI
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