Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | OS016952 | PA |
N | 2086S0102X | Surgical Critical Care | 3291 | TN |
NPI | 1063774537 |
---|---|
Provider Name | Dr. Keith Habeeb |
First Address | Nashville, TN 37203-5573 |
Second Address | Nashville, TN 37203-1538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 27/01/2022 |