Provider Demographics
NPI:1831418151
Name:HABBU, ROHAN ASHOK (MS, MBBS)
Entity type:Individual
Prefix:
First Name:ROHAN
Middle Name:ASHOK
Last Name:HABBU
Suffix:
Gender:M
Credentials:MS, MBBS
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1422 DEWBERRY PL NE
Mailing Address - Street 2:APT 16
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-6918
Mailing Address - Country:US
Mailing Address - Phone:616-717-3860
Mailing Address - Fax:
Practice Address - Street 1:1422 DEWBERRY PL NE
Practice Address - Street 2:APT 16
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-6918
Practice Address - Country:US
Practice Address - Phone:616-717-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ZZ2002031777207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery