Provider Demographics
NPI:1851403778
Name:HUSSAINI, SYED AIJAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:AIJAZ
Last Name:HUSSAINI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5542 FOREST GLEN RD
Mailing Address - Street 2:SYED A HUSSAINI MD INC
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-2388
Mailing Address - Country:US
Mailing Address - Phone:440-228-1673
Mailing Address - Fax:440-428-4661
Practice Address - Street 1:5542 FOREST GLEN RD
Practice Address - Street 2:SYED A HUSSAINI MD INC
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2388
Practice Address - Country:US
Practice Address - Phone:440-428-4661
Practice Address - Fax:440-428-4661
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-05-31
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Provider Licenses
StateLicense IDTaxonomies
OH35041030207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA77632Medicaid
OH0338736Medicaid
A77632Medicare UPIN
OHA77632Medicaid