Healthcare Provider Details

I. General information

NPI: 1891711875
Provider Name (Legal Business Name): THOMAS & HUSAIN MEDICAL ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48681 CALCUTTA SMITHFERRY RD
E LIVERPOOL OH
43920-9006
US

IV. Provider business mailing address

PO BOX 2346 48681 CALCUTTA SMITHFERRY RD
E LIVERPOOL OH
43920-0346
US

V. Phone/Fax

Practice location:
  • Phone: 330-385-4004
  • Fax: 330-385-3949
Mailing address:
  • Phone: 330-385-4004
  • Fax: 330-385-3949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MUMTAZ JAMAL HUSAIN
Title or Position: MD PHYSICIAN
Credential: MD
Phone: 330-385-4004