Provider Demographics
NPI:1043539919
Name:MOUSTAFA HUSSEIN, WESAM HASSEN (MD)
Entity Type:Individual
Prefix:
First Name:WESAM
Middle Name:HASSEN
Last Name:MOUSTAFA HUSSEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13326 HORSEPEN WOODS LANE
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171
Mailing Address - Country:US
Mailing Address - Phone:609-335-6595
Mailing Address - Fax:
Practice Address - Street 1:13326 HORSEPEN WOODS LANE
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171
Practice Address - Country:US
Practice Address - Phone:609-335-6595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440869207R00000X, 208M00000X
DCMD039045207R00000X
VA0101250764207RI0200X
MDD88893207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist