Provider Demographics
NPI:1710287636
Name:HUSSAIN, SYED A (R PH)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:A
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13814 OUTLET DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4970
Mailing Address - Country:US
Mailing Address - Phone:301-890-7015
Mailing Address - Fax:301-890-2058
Practice Address - Street 1:13814 OUTLET DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4970
Practice Address - Country:US
Practice Address - Phone:301-890-7015
Practice Address - Fax:301-890-2058
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist