Provider Demographics
NPI:1548656770
Name:HABIBI, BEHNUM (MD)
Entity type:Individual
Prefix:DR
First Name:BEHNUM
Middle Name:
Last Name:HABIBI
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 1:3500 N BROAD ST # 1A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4106
Mailing Address - Country:US
Mailing Address - Phone:215-707-3646
Mailing Address - Fax:
Practice Address - Street 1:9155 SW BARNES RD STE 836
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6635
Practice Address - Country:US
Practice Address - Phone:503-210-5195
Practice Address - Fax:503-303-8405
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD471173208100000X
ORMD2222202081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation