Individual
THOMAS J HABERKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9500 EUCLID AVE, DESK A71, CLEVELAND, OH 44195-0001
(216) 444-6696
(216) 445-9409
Mailing address
9500 EUCLID AVE, DESK A71, CLEVELAND, OH 44195-0001
(216) 444-6696
(216) 445-9409
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036072778
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1627261
BCBS PROVIDER ID
IL
05
—
3113553
—
OH
01
—
610797100
WORKERS COMPENSATION
IL
01
—
P00160607
RAILROAD MEDICARE
IL
Enumeration date
09/23/2005
Last updated
10/14/2011
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