Provider Demographics
NPI:1912106279
Name:HABERLIN, WILLIAM J II (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:HABERLIN
Suffix:II
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6507 DEER POINTE DR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1667
Mailing Address - Country:US
Mailing Address - Phone:105-439-3324
Mailing Address - Fax:410-543-9237
Practice Address - Street 1:6507 DEER POINTE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1667
Practice Address - Country:US
Practice Address - Phone:410-543-9332
Practice Address - Fax:410-543-9237
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0077364208600000X
NC2013-00151208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC1840Medicaid
NCNCE730AMedicare PIN
SCNC1840Medicaid