Provider Demographics
NPI:1164487377
Name:HABIB, MAGDY A (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:A
Last Name:HABIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 SKYLYN DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1040
Mailing Address - Country:US
Mailing Address - Phone:864-585-3608
Mailing Address - Fax:864-585-3745
Practice Address - Street 1:1702 SKYLYN DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1040
Practice Address - Country:US
Practice Address - Phone:864-585-3608
Practice Address - Fax:864-585-3745
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8147174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD174621754OtherPTAN
SC1754Medicare PIN
SCD17462Medicare UPIN
SCD174621754OtherPTAN