Provider Demographics
NPI:1184685604
Name:HABASH, RAMEZ J (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMEZ
Middle Name:J
Last Name:HABASH
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 1:3601 LAKE PARK LN
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-2581
Mailing Address - Country:US
Mailing Address - Phone:402-984-9696
Mailing Address - Fax:
Practice Address - Street 1:715 N KANSAS AVE
Practice Address - Street 2:# 202
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4438
Practice Address - Country:US
Practice Address - Phone:402-463-2344
Practice Address - Fax:402-463-2355
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23533207RN0300X, 207R00000X, 207RN0300X
GA055233207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1229OtherGROUP PTAN
NENA1229OtherGROUP PTAN
I51128Medicare UPIN