Individual
AMANDA ELAINE DAHO-HABEEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402
(601) 296-2090
(601) 296-2089
Mailing address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 296-2090
(601) 296-2089
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
20310
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061320001
—
MS
05
—
207288606
—
MO
01
—
7727820
AETNA
MS
01
—
P00676188
RAILROAD MEDICARE
MS
Enumeration date
08/20/2006
Last updated
09/30/2019
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