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General NPI Number Information
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NPI Number | 1225306855
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Entity Type | Individual
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Provider Name | RAOUF HUSSAIN B.SC., PH.D., M.B.A.
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Gender | Male
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Dates
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Enumeration Date | 12/10/2011
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Last Update Date | 12/10/2011
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Provider Practice Location Address
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Address Line | 2712 COTTAGE LOOP
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City | PARK CITY
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State | UT
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Zip | 84098-8261
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Country | US
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Telephone | 435-655-7938
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 COTTAGE LOOP
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City | PARK CITY
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State | UT
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Zip | 84098-8261
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Country | US
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Telephone | 435-655-7938
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 7022112-1701
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9436
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17633
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6318
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License Number State | ID
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