Provider Demographics
NPI:1841387719
Name:HUSSAIN, REHANA A (MD)
Entity Type:Individual
Prefix:
First Name:REHANA
Middle Name:A
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 QUINCE APPLE COURT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772
Mailing Address - Country:US
Mailing Address - Phone:301-893-0666
Mailing Address - Fax:301-893-1604
Practice Address - Street 1:7 POST OFFICE ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-893-0666
Practice Address - Fax:301-893-1604
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00435572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD370491200Medicaid
MD166MMedicare PIN
MD260034757Medicare PIN
G14008Medicare UPIN
DC796430Medicare PIN