MEDICARE: DR. HANY M HABASHY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	26072	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060064485	OTHER	TN	RR MEDICARE

General Provider Information

NPI Number	:	1285632224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HANY M HABASHY MD

Provider Business Mailing Address
First Line	:	2693 UNION AVENUE EXT STE 100
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-4403
Country	:	US
Telephone Number	:	901-726-0843
Fax Number	:

Provider Business Practice Location Address
First Line	:	2693 UNION AVENUE EXT STE 100
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38112-4403
Country	:	US
Telephone Number	:	901-726-0843
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	04/06/2023

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