Provider Demographics
NPI:1891731840
Name:HABEEB, EDWARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:D
Last Name:HABEEB
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 1:2331 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1111
Mailing Address - Country:US
Mailing Address - Phone:540-725-1226
Mailing Address - Fax:540-857-5306
Practice Address - Street 1:2331 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1111
Practice Address - Country:US
Practice Address - Phone:540-725-1226
Practice Address - Fax:540-857-5306
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030844207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1891731840OtherVIRGINIA PREMIER
VA1891731840Medicaid
VA1891731840OtherANTHEM
VA1891731840OtherHUMANA MEDICARE
VA1891731840OtherAETNA
VA1891731840OtherIN-TOTAL
VA1891731840OtherOPTIMA HEALTH PLAN
VA1891731840OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1891731840OtherGATEWAY
VA1891731840OtherUNITED HEALTHCARE
VA1891731840OtherVIRGINIA HEALTH NETWORK
VA1891731840OtherHEALTHKEEPERS
VA1891731840OtherUMWA
VA1891731840OtherTRICARE
VA1891731840OtherHEALTHKEEPERS PLUS
VA1891731840OtherCIGNA
VAP01668291OtherRAILROAD MEDICARE
VA1891731840OtherGATEWAY
VA1891731840OtherOPTIMA HEALTH PLAN