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General NPI Number Information
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NPI Number | 1306000179
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Entity Type | Individual
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Provider Name | HUSSAM SEIF EDDEINE MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 2979 W ELLIOT RD STE 2
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City | CHANDLER
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State | AZ
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Zip | 85224-1641
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Country | US
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Telephone | 480-939-3037
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Fax | 480-939-3173
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Provider Business Mailing Address
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Address Line | PO BOX 27388
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City | TEMPE
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State | AZ
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Zip | 85285-7388
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Country | US
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Telephone | 480-939-3037
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Fax | 480-939-3173
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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 | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 45302
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 45302
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License Number State | AZ
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