Provider Demographics
NPI:1245233717
Name:HUSSEIN, FATIMA YOUSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:YOUSEF
Last Name:HUSSEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11649 VIXENS PATH
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1541
Mailing Address - Country:US
Mailing Address - Phone:301-873-0248
Mailing Address - Fax:
Practice Address - Street 1:320 LINCOLN BLVD SUITE #100
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-9029
Practice Address - Country:US
Practice Address - Phone:310-697-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD55455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD398SMedicare PIN
DC491749Medicare PIN
MDH11539Medicare UPIN