Provider Demographics
NPI:1861408734
Name:HUSAIN, SYED NASIR (M D)
Entity type:Individual
Prefix:
First Name:SYED
Middle Name:NASIR
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43303 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1959
Mailing Address - Country:US
Mailing Address - Phone:586-739-8674
Mailing Address - Fax:586-739-5567
Practice Address - Street 1:43303 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1959
Practice Address - Country:US
Practice Address - Phone:586-739-8674
Practice Address - Fax:586-739-5567
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052121207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4148705-10Medicaid
MIM89200001Medicare PIN
MIF02014Medicare UPIN