MEDICARE: HUSEIN YUSUF HUSEIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	36.004099	OH
2	213ES0103X	Foot & Ankle Surgery Podiatrist	5951001379	MI

General Provider Information

NPI Number	:	1265056410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUSEIN YUSUF HUSEIN DPM

Provider Business Mailing Address
First Line	:	4318 WEDGEWOOD DR
Second Line	:
City	:	COPLEY
State	:	OH
Zip	:	44321-1268
Country	:	US
Telephone Number	:	330-631-5631
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 BROAD ST
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-1851
Country	:	US
Telephone Number	:	330-334-1534
Fax Number	:	440-255-9400

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2020
Last Update Date	:	06/03/2025

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