MEDICARE: CHRISTA HABELA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	6809	MD

General Provider Information

NPI Number	:	1780909671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTA HABELA M.D.

Provider Business Mailing Address
First Line	:	1620 13TH PL S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-6604
Country	:	US
Telephone Number	:	205-746-0009
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N WOLFE ST
Second Line	:	CMSC 2-124
City	:	BALTIMORE
State	:	MD
Zip	:	21287-3224
Country	:	US
Telephone Number	:	410-955-6553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2010
Last Update Date	:	04/02/2010

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