Healthcare Provider Details

I. General information

NPI: 1972568533
Provider Name (Legal Business Name): HUSEIN Q CAMPWALA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 LINCOLN ST
FRAMINGHAM MA
01702-6327
US

IV. Provider business mailing address

123 SUN CT
NEWARK DE
19711-3413
US

V. Phone/Fax

Practice location:
  • Phone: 508-383-8510
  • Fax:
Mailing address:
  • Phone: 302-633-5525
  • Fax: 302-633-5214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number41076
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: