Provider Demographics
NPI:1669492997
Name:HUSSAIN, FARID (MD)
Entity Type:Individual
Prefix:DR
First Name:FARID
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 9TH ST SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-4312
Mailing Address - Country:US
Mailing Address - Phone:772-257-8224
Mailing Address - Fax:772-213-3157
Practice Address - Street 1:1553 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5735
Practice Address - Country:US
Practice Address - Phone:772-257-8224
Practice Address - Fax:772-213-3157
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119096208000000X
WV20614208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME119096OtherSTATE LICENSE
WV0022360001Medicaid
WV001714000OtherBCBS
WV001706661OtherBCBS
WV3810000231Medicaid
WV0035334000Medicaid
WV0022360001Medicaid
WV3810000231Medicaid
WV511856Medicare Oscar/Certification
WVHU4059891Medicare PIN
WV5118601Medicare Oscar/Certification
WV511860Medicare Oscar/Certification