Provider Demographics
NPI:1093274995
Name:DEBESSAI, HABEN
Entity Type:Individual
Prefix:
First Name:HABEN
Middle Name:
Last Name:DEBESSAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 CENTENNIAL OLYMPIC PARK DR NW UNIT 1508
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30313-1954
Mailing Address - Country:US
Mailing Address - Phone:517-285-9150
Mailing Address - Fax:
Practice Address - Street 1:325 CENTENNIAL OLYMPIC PARK DR NW UNIT 1508
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-1954
Practice Address - Country:US
Practice Address - Phone:517-285-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1093274995207V00000X
390200000X
GA95946207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program