Habenicht, Laurence

Habenicht, Laurence is an individual health care provider with primary practice located at 42 N Saint Joseph Ave Suite100, Niles MI 49120-2203. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Other Service Providers / Specialist is his primary health care specialty. Habenicht, Laurence can be contacted via phone (269) 684-6696.

Contact Information

Primary practice address
42 N Saint Joseph Ave Suite100 Niles MI 49120-2203
Phone: (269) 684-6696
Fax: (269) 684-5286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4301074430 Michigan
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301074430 Michigan

Profile Details

NPI number 1851363618
LBN Legal business name Habenicht, Laurence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Mar 11th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851363618 NPPES
Michigan MEDICAID 411815210

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