Provider Demographics
NPI:1629079769
Name:HUSAIN, ZEESHAN SHAHRIAR (DPM)
Entity Type:Individual
Prefix:DR
First Name:ZEESHAN
Middle Name:SHAHRIAR
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32743 23 MILE RD
Mailing Address - Street 2:STE 210
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2082
Mailing Address - Country:US
Mailing Address - Phone:586-725-3444
Mailing Address - Fax:586-725-0984
Practice Address - Street 1:32743 23 MILE RD
Practice Address - Street 2:STE 210
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-2082
Practice Address - Country:US
Practice Address - Phone:586-725-3444
Practice Address - Fax:586-725-0984
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002007213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4507230Medicaid
MIE06226014Medicare PIN
MA0420490001Medicare NSC
MI4507230Medicaid
MI0M91010003Medicare PIN
MI6087740001Medicare NSC
MIP00044715OtherMCRR
MI480F330020OtherBCBS
MI4507230Medicaid