Provider Demographics
NPI:1265639397
Name:HUSAIN, MINHAJ U (MD)
Entity Type:Individual
Prefix:
First Name:MINHAJ
Middle Name:U
Last Name:HUSAIN
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 1:4600 W LOOMIS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4858
Mailing Address - Country:US
Mailing Address - Phone:414-281-4466
Mailing Address - Fax:414-365-3225
Practice Address - Street 1:4600 W LOOMIS RD STE 201
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220
Practice Address - Country:US
Practice Address - Phone:414-281-4466
Practice Address - Fax:414-365-3225
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52146207RI0200X
WI52146-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1265639397Medicaid
WI1265639397Medicaid