Provider Demographics
NPI:1215932223
Name:HABAL, NIZAR (MD)
Entity type:Individual
Prefix:
First Name:NIZAR
Middle Name:
Last Name:HABAL
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 1:2223 HEMBY LANE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2868
Mailing Address - Country:US
Mailing Address - Phone:252-413-0036
Mailing Address - Fax:252-413-0038
Practice Address - Street 1:2223 HEMBY LANE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2868
Practice Address - Country:US
Practice Address - Phone:252-413-0036
Practice Address - Fax:252-413-0038
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000442208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC126T0OtherBCBS
NC89126T0Medicaid
NC89126T0Medicaid