Provider Demographics
NPI:1982615746
Name:HUSSAIN, KHWAJA NMI (MD)
Entity type:Individual
Prefix:DR
First Name:KHWAJA
Middle Name:NMI
Last Name:HUSSAIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1401 W. ASH STREET - CHERRY HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-1078
Mailing Address - Country:US
Mailing Address - Phone:919-751-8337
Mailing Address - Fax:
Practice Address - Street 1:CHERRY HOSPITAL
Practice Address - Street 2:1401 W. ASH STREET
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1078
Practice Address - Country:US
Practice Address - Phone:919-947-8237
Practice Address - Fax:919-705-5140
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2020-09-23
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Provider Licenses
StateLicense IDTaxonomies
NC9701411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG86226Medicare UPIN