MEDICARE: MOHAMMED BELAYET HUSSAIN MD

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	208800000X	Urology Physician	35058894	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639179054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED BELAYET HUSSAIN MD

Provider Business Mailing Address
First Line	:	3130 N DIXIE HWY
Second Line	:	STE. 205
City	:	TROY
State	:	OH
Zip	:	45373-1337
Country	:	US
Telephone Number	:	937-335-0061
Fax Number	:	937-339-9336

Provider Business Practice Location Address
First Line	:	3130 N DIXIE HWY
Second Line	:	STE. 205
City	:	TROY
State	:	OH
Zip	:	45373-1337
Country	:	US
Telephone Number	:	937-335-0061
Fax Number	:	937-339-9336

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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