Provider Demographics
NPI:1194041038
Name:HUSSAIN, BALAL (MD)
Entity Type:Individual
Prefix:DR
First Name:BALAL
Middle Name:
Last Name:HUSSAIN
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 1:7575 GRAND RIVER RD STE 209
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9379
Mailing Address - Country:US
Mailing Address - Phone:810-844-7950
Mailing Address - Fax:
Practice Address - Street 1:7575 GRAND RIVER RD STE 209
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9379
Practice Address - Country:US
Practice Address - Phone:810-844-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program