Healthcare Provider Details

I. General information

NPI: 1033325469
Provider Name (Legal Business Name): NAUSHIN HOSSAIN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22250 PROVIDENCE DR SUITE 500
SOUTHFIELD MI
48075-4825
US

IV. Provider business mailing address

8213 JEREMY RD
VAN BUREN TWP MI
48111-5384
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3441
  • Fax:
Mailing address:
  • Phone: 734-325-2312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301083598
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: