Healthcare Provider Details

I. General information

NPI: 1730324070
Provider Name (Legal Business Name): MAZHER HUSSAIN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 W HURON ST SUITE 608
PONTIAC MI
48341-1601
US

IV. Provider business mailing address

461 W HURON ST SUITE 608
PONTIAC MI
48341-1601
US

V. Phone/Fax

Practice location:
  • Phone: 248-857-6889
  • Fax:
Mailing address:
  • Phone: 248-857-6889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MAZHER HUSSAIN
Title or Position: OWNER
Credential: M.D.
Phone: 248-857-7583