Provider Demographics
NPI:1487008397
Name:ASMARO, HABIB
Entity Type:Individual
Prefix:
First Name:HABIB
Middle Name:
Last Name:ASMARO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HABIB
Other - Middle Name:
Other - Last Name:HABIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:4133 OGLETOWN STANTON RD FL 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4168
Practice Address - Country:US
Practice Address - Phone:302-292-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC96101223S0112X, 204E00000X
390200000X
DEG1-00115161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program