Provider Demographics
NPI:1891731345
Name:DIAA E HUSSEIN MD LLC
Entity Type:Organization
Organization Name:DIAA E HUSSEIN MD LLC
Other - Org Name:GREENWAY FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-438-8577
Mailing Address - Street 1:PO BOX 3086
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-3086
Mailing Address - Country:US
Mailing Address - Phone:828-438-8577
Mailing Address - Fax:828-438-8507
Practice Address - Street 1:329 SANFORD DR
Practice Address - Street 2:SUITE B
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2555
Practice Address - Country:US
Practice Address - Phone:828-430-9120
Practice Address - Fax:828-430-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherEIN