Provider Demographics
NPI:1306899984
Name:HABASHY, SHAWKY (MD)
Entity type:Individual
Prefix:MR
First Name:SHAWKY
Middle Name:
Last Name:HABASHY
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 1:4327 W. 13TH ST.
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212
Mailing Address - Country:US
Mailing Address - Phone:316-722-6109
Mailing Address - Fax:316-722-6230
Practice Address - Street 1:2121 N TYLER RD
Practice Address - Street 2:STE 210
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-4920
Practice Address - Country:US
Practice Address - Phone:316-722-6109
Practice Address - Fax:316-722-6230
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS418598174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist