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Individual

SASHA JENKINS HABERLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, MPH

Contact information

Practice address
10502 PARK RD, STE 100, CHARLOTTE, NC 28210-8479
(980) 299-3926
(980) 299-6736
Mailing address
10502 PARK RD, SUITE 100, CHARLOTTE, NC 28210-8479
(980) 299-3926
(980) 299-6736

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
2016-00779
NC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
35. 123300
OH
207ND0101X
MOHS-Micrographic Surgery Physician
69679
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000877564
ANTHEM BLUE CROSS/BLUE SHIELD
OH
01
P01486806
RAILROAD MEDICARE
Enumeration date
04/21/2010
Last updated
04/20/2017
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