Provider Demographics
NPI:1689903130
Name:AKHTAR HUSAIN, MD PC
Entity Type:Organization
Organization Name:AKHTAR HUSAIN, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AKHTAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-675-1150
Mailing Address - Street 1:14720 KING RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7945
Mailing Address - Country:US
Mailing Address - Phone:734-675-1150
Mailing Address - Fax:734-675-1173
Practice Address - Street 1:14720 KING RD
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-7945
Practice Address - Country:US
Practice Address - Phone:734-675-1150
Practice Address - Fax:734-675-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088891208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty