Healthcare Provider Details

I. General information

NPI: 1821403411
Provider Name (Legal Business Name): ZAFAR HUSSAIN INTERNAL MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 W 23RD ST STE P
PANAMA CITY FL
32405-2924
US

IV. Provider business mailing address

PO BOX 15548
PANAMA CITY FL
32406-5548
US

V. Phone/Fax

Practice location:
  • Phone: 850-481-1032
  • Fax: 850-481-1437
Mailing address:
  • Phone: 850-481-1032
  • Fax: 850-481-1437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME103366
License Number StateFL

VIII. Authorized Official

Name: DR. ZAFAR HUSSAIN
Title or Position: OWNER
Credential: M.D.
Phone: 850-257-6668