MEDICARE: HUFSA HUSSAN

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	0103301300	VA

General Provider Information

NPI Number	:	1326562182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUFSA HUSSAN

Provider Business Mailing Address
First Line	:	6130 OXON HILL RD STE 305
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-3168
Country	:	US
Telephone Number	:	301-567-5005
Fax Number	:

Provider Business Practice Location Address
First Line	:	PROGRESSIVE FEET LLC
Second Line	:	6130 OXON HILL RD STE 305
City	:	OXON HILL
State	:	MD
Zip	:	20745-3168
Country	:	US
Telephone Number	:	301-567-5005
Fax Number	:

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

Provider Enumeration Date	:	08/02/2017
Last Update Date	:	12/27/2022

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