Provider Demographics
NPI:1306826433
Name:HUSSAIN, SABIHA M (MD)
Entity Type:Individual
Prefix:
First Name:SABIHA
Middle Name:M
Last Name:HUSSAIN
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 1:3400 SPRUCE STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4228
Mailing Address - Country:US
Mailing Address - Phone:215-662-2638
Mailing Address - Fax:215-349-5703
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4228
Practice Address - Country:US
Practice Address - Phone:215-662-2638
Practice Address - Fax:215-349-5703
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10929400207RN0300X
PAMD427230207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101397361Medicaid
PA101397361Medicaid
PAI43406Medicare UPIN
PA1013973610002Medicaid
PA1013973610001Medicaid
PAP00379462Medicare PIN
PAI43406Medicare UPIN
PA095126NJ3Medicare PIN
OH2600055Medicaid