Provider Demographics
NPI:1518417989
Name:HUSSAIN, MUHAMMAD JAWAD (RPT)
Entity Type:Individual
Prefix:MR
First Name:MUHAMMAD
Middle Name:JAWAD
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7254 SILVER LEAF LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3330
Mailing Address - Country:US
Mailing Address - Phone:248-252-9954
Mailing Address - Fax:
Practice Address - Street 1:7254 SILVER LEAF LN
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3330
Practice Address - Country:US
Practice Address - Phone:248-252-9954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017188225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist