Provider Demographics
NPI:1609933027
Name:HABA, SADIK N (MD)
Entity Type:Individual
Prefix:
First Name:SADIK
Middle Name:N
Last Name:HABA
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 1:1301 SIGMAN RD NE
Mailing Address - Street 2:STE 100
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3812
Mailing Address - Country:US
Mailing Address - Phone:770-760-9360
Mailing Address - Fax:
Practice Address - Street 1:1301 SIGMAN RD NE
Practice Address - Street 2:STE 100
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3812
Practice Address - Country:US
Practice Address - Phone:770-760-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA230715207L00000X
GA67225207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA067225OtherLICENSE