Provider Demographics
NPI:1629049903
Name:HYDER, HUMA MAHNAZ (MD)
Entity Type:Individual
Prefix:MRS
First Name:HUMA
Middle Name:MAHNAZ
Last Name:HYDER
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 1:155 KINGSLEY LN STE 320
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4629
Mailing Address - Country:US
Mailing Address - Phone:757-489-4700
Mailing Address - Fax:
Practice Address - Street 1:155 KINGSLEY LN STE 320
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4629
Practice Address - Country:US
Practice Address - Phone:757-489-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012386352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010347581Medicaid
VA186351OtherANTHM
VA010347581Medicaid
VA00X290L01Medicare PIN