Healthcare Provider Details

I. General information

NPI: 1780696567
Provider Name (Legal Business Name): ASIMA S HUSSAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 HIGHLAND RD STE 130
WATERFORD MI
48328-2168
US

IV. Provider business mailing address

PO BOX 7377
BLOOMFIELD HILLS TWP MI
48302-7377
US

V. Phone/Fax

Practice location:
  • Phone: 248-681-7909
  • Fax: 248-681-0455
Mailing address:
  • Phone: 248-672-8319
  • Fax: 586-578-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number4301053641
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: