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General NPI Number Information
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NPI Number | 1912000696
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Entity Type | Individual
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Provider Name | KISHWAR HUSAIN MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 300 HEALTH PARK BLVD SUITE 4000
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3707
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Country | US
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Telephone | 904-824-8666
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Fax | 904-824-8933
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Provider Business Mailing Address
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Address Line | 300 HEALTH PARK BLVD STE 4000
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3704
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Country | US
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Telephone | 412-822-7410
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Fax | 412-822-7411
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME68363
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License Number State | FL
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