Individual
DR. MARK LEON HABERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 MEMORIAL DR, SUITE 214, LEOMINSTER, MA 01453-2238
(978) 534-6863
(978) 534-3417
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38236
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173088
—
MA
01
—
038236
TUFFS
MA
01
—
24144
FALLON SELECT
MA
01
—
61995
HAVARD PILGRIM
MA
01
—
B01037
BLUE SHIELD
MA
Enumeration date
09/07/2006
Last updated
11/16/2011
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