Provider Demographics
NPI:1720045453
Name:HUSSEIN, MAGED (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGED
Middle Name:
Last Name:HUSSEIN
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:PO BOX 3171
Mailing Address - Street 2:
Mailing Address - City:OAKTON
Mailing Address - State:VA
Mailing Address - Zip Code:22124-9171
Mailing Address - Country:US
Mailing Address - Phone:703-242-2335
Mailing Address - Fax:703-242-0633
Practice Address - Street 1:2555 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181-5517
Practice Address - Country:US
Practice Address - Phone:703-242-2335
Practice Address - Fax:703-242-0633
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA676562Medicare ID - Type Unspecified