Individual
DR. AYSHA HABIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
12320 W BROAD ST STE 204, HENRICO, VA 23233-7603
(804) 612-2980
(804) 762-7102
Mailing address
5207 HICKORY PARK DR, SUITE A, GLEN ALLEN, VA 23059-2624
(804) 612-2980
(804) 762-7102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101243074
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06695
GROUP PTAN
VA
Enumeration date
06/29/2007
Last updated
09/30/2021
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