Physician Compare National (NPI:1255336673)

HEALTHCARE PROVIDER: CRAIG G HABER MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1255336673
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022098771
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040722001010
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HABER
	Individual professional last name
Provider First Name	CRAIG
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PRIVIA MEDICAL GROUP, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4385682061
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	967
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	133 DEFENSE HWY
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	ANNAPOLIS
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	214017015
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREATER BALTIMORE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210040
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTHWEST HOSPITAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	390065
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GETTYSBURG HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y