Healthcare Provider Details

I. General information

NPI: 1538356696
Provider Name (Legal Business Name): MOHAMED AND REHANA HUSSAIN MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 11/28/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 POST OFFICE RD STE A
WALDORF MD
20602-2744
US

IV. Provider business mailing address

10100 QUINCE APPLE CT
UPPER MARLBORO MD
20772-3871
US

V. Phone/Fax

Practice location:
  • Phone: 301-893-0666
  • Fax: 301-934-9321
Mailing address:
  • Phone: 301-893-0666
  • Fax: 301-934-9321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberD43557
License Number StateMD

VIII. Authorized Official

Name: REHANA A HUSSAIN
Title or Position: MD, PRESIDENT
Credential: MD
Phone: 301-943-4443