Haeberlein, Robert Wynne

Haeberlein, Robert Wynne is an sole proprietor health care provider with primary practice located at 700 Mount Hope Avenue Suite 601 , Bangor ME 04401-5600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Haeberlein, Robert Wynne can be contacted via phone (207) 942-4653.

Contact Information

Primary practice address
700 Mount Hope Avenue Suite 601 Bangor ME 04401-5600
Fax: (207) 990-4795
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 009794 Maine

Profile Details

NPI number 1104919901
LBN Legal business name Haeberlein, Robert Wynne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Jun 22nd, 2009 - about 16 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 1104919901 NPPES
Maine MEDICAID 110090000

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