Provider Demographics
NPI:1679863849
Name:HUSAIN, ANWAR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ANWAR
Middle Name:
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 609; ROOM D185 MAYO
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-624-8133
Mailing Address - Fax:612-625-3976
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MMC 609; ROOM D185 MAYO
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0341
Practice Address - Country:US
Practice Address - Phone:612-624-8133
Practice Address - Fax:612-625-3976
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program