Healthcare Provider Details

I. General information

NPI: 1386095560
Provider Name (Legal Business Name): MUHAMMAD GHAZANFAR HUSNAIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 03/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE UNIVERSITY HOSPITALS CASE MEDICAL CENTER
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

26500 AMHEARST CIR APT 102
BEACHWOOD OH
44122-8503
US

V. Phone/Fax

Practice location:
  • Phone: 216-844-2562
  • Fax:
Mailing address:
  • Phone: 216-333-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.132370
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57.027544
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: