Healthcare Provider Details

I. General information

NPI: 1053229724
Provider Name (Legal Business Name): MARIAM HUSSAIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 ENVIRON WAY
CHAPEL HILL NC
27517-4418
US

IV. Provider business mailing address

22102 ROSE GARDEN LN APT 22-102
DURHAM NC
27707-6811
US

V. Phone/Fax

Practice location:
  • Phone: 919-942-8738
  • Fax:
Mailing address:
  • Phone: 678-502-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35009
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: