Healthcare Provider Details

I. General information

NPI: 1306025739
Provider Name (Legal Business Name): SAIFUDIN ABDELLA HUSSEIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8116 GOOD LUCK RD STE 305
LANHAM MD
20706-3508
US

IV. Provider business mailing address

8116 GOOD LUCK RD STE 305
LANHAM MD
20706-3508
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-1200
  • Fax: 301-552-1201
Mailing address:
  • Phone: 301-345-8000
  • Fax: 301-345-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0063586
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: