=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497735211
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT F HABER
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2006
-----------------------------------------------------
Last Update Date | 01/23/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1208 N CENTER ST FOOT HEALTH CENTER OF HICKORY
-----------------------------------------------------
City | HICKORY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28601-3760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-322-1391
-----------------------------------------------------
Fax | 828-322-1392
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1208 N CENTER ST FOOT HEALTH CENTER OF HICKORY
-----------------------------------------------------
City | HICKORY
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28601-3760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-322-1391
-----------------------------------------------------
Fax | 828-322-1392
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0131X
-----------------------------------------------------
Taxonomy Name | Foot Surgery Podiatrist
-----------------------------------------------------
License Number | 246
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213EP1101X
-----------------------------------------------------
Taxonomy Name | Primary Podiatric Medicine Podiatrist
-----------------------------------------------------
License Number | 246
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------