Healthcare Provider Details

I. General information

NPI: 1194246736
Provider Name (Legal Business Name): HUSSEIN OSMAN DAOUD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date: 02/08/2018
Reactivation Date: 02/13/2018

III. Provider practice location address

395 W BULLDOG BLVD
PROVO UT
84604-3311
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number14087019-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number8985
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: