Provider Demographics
NPI:1821185083
Name:HABIBA TUNAU MD PLLC
Entity Type:Organization
Organization Name:HABIBA TUNAU MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HABIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUNAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-266-0062
Mailing Address - Street 1:612 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-4536
Mailing Address - Country:US
Mailing Address - Phone:910-266-0062
Mailing Address - Fax:910-277-9208
Practice Address - Street 1:612 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4536
Practice Address - Country:US
Practice Address - Phone:910-266-0062
Practice Address - Fax:910-277-9208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00989207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905553Medicaid
NC2327233Medicare PIN
NC5905553Medicaid