Healthcare Provider Details

I. General information

NPI: 1851583579
Provider Name (Legal Business Name): HAITHAM M HUSSEIN MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 PHALEN BLVD MAIL STOP 41104C HEALTHPARTNERS SPECIALTY CENTER 401
SAINT PAUL MN
55130-5302
US

IV. Provider business mailing address

PO BOX 1309 8170 33RD AVE S - MS 21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-7900
  • Fax: 651-254-7904
Mailing address:
  • Phone: 651-254-7900
  • Fax: 651-254-7904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number58060
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberP3897
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: