Healthcare Provider Details

I. General information

NPI: 1700865722
Provider Name (Legal Business Name): ASSEM HOUSSEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 N COLUMBUS ST SUITE 130
LANCASTER OH
43130-8185
US

IV. Provider business mailing address

2405 N COLUMBUS ST SUITE 130
LANCASTER OH
43130-8185
US

V. Phone/Fax

Practice location:
  • Phone: 740-689-6710
  • Fax: 740-689-6712
Mailing address:
  • Phone: 740-689-6710
  • Fax: 740-689-6712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number35.066193
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: