Provider Demographics
NPI:1013939115
Name:TUNAU, HABIBA (MD)
Entity Type:Individual
Prefix:DR
First Name:HABIBA
Middle Name:
Last Name:TUNAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 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
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00989207R00000X
NY233291207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905582Medicaid
NYI21863Medicare UPIN
NC5905582Medicaid