Healthcare Provider Details

I. General information

NPI: 1356385371
Provider Name (Legal Business Name): SHABBAR HUSSAIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20311 LAPPANS RD STE 100
BOONSBORO MD
21713-2085
US

IV. Provider business mailing address

1120 PROFESSIONAL CT
HAGERSTOWN MD
21740-8040
US

V. Phone/Fax

Practice location:
  • Phone: 301-432-8470
  • Fax: 301-432-4010
Mailing address:
  • Phone: 301-760-3226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD039475L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberD0031919
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberMD2017-0572
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: