Provider Demographics
NPI:1295827251
Name:HUSSEINI, FALEH (MD)
Entity Type:Individual
Prefix:DR
First Name:FALEH
Middle Name:
Last Name:HUSSEINI
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 1:25650 KELLY RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4904
Mailing Address - Country:US
Mailing Address - Phone:586-777-2005
Mailing Address - Fax:586-777-2886
Practice Address - Street 1:25650 KELLY RD
Practice Address - Street 2:SUITE 10
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4904
Practice Address - Country:US
Practice Address - Phone:586-777-2005
Practice Address - Fax:586-777-2886
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301034270207V00000X
MIFH034270174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1092722Medicaid
MI1092722Medicaid