Provider Demographics
NPI:1508933458
Name:HUSSEINI, ABLA MALEK (MD)
Entity Type:Individual
Prefix:DR
First Name:ABLA
Middle Name:MALEK
Last Name:HUSSEINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-822-4355
Mailing Address - Fax:
Practice Address - Street 1:8110 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5116
Practice Address - Country:US
Practice Address - Phone:804-320-8160
Practice Address - Fax:804-320-2189
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1508933458Medicaid
VA00X6027Q04Medicare PIN
VA019035P95Medicare PIN
VA019035P95 - C03895Medicare PIN