Provider Demographics
NPI:1962725010
Name:HABIGAILE CRIBE, MD LLC
Entity type:Organization
Organization Name:HABIGAILE CRIBE, MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HABIGAILE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-374-5582
Mailing Address - Street 1:911 PLAZA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-6785
Mailing Address - Country:US
Mailing Address - Phone:478-374-5582
Mailing Address - Fax:
Practice Address - Street 1:33 S SECOND AVE
Practice Address - Street 2:
Practice Address - City:MC RAE
Practice Address - State:GA
Practice Address - Zip Code:31055-4658
Practice Address - Country:US
Practice Address - Phone:229-868-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty