Healthcare Provider Details

I. General information

NPI: 1073833745
Provider Name (Legal Business Name): ARIF BILAL HUSSAIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8687 CONNECTICUT ST STE D
MERRILLVILLE IN
46410-5541
US

IV. Provider business mailing address

PO BOX 10685
MERRILLVILLE IN
46411-0685
US

V. Phone/Fax

Practice location:
  • Phone: 219-750-9630
  • Fax: 219-750-9451
Mailing address:
  • Phone: 219-750-9630
  • Fax: 219-750-9451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number02004595A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: