Provider Demographics
NPI:1942756291
Name:HUSSAIN, BATOOL (MD)
Entity Type:Individual
Prefix:DR
First Name:BATOOL
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3901 BEAUBIEN STREET,
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF MIPEDIATRIC EDUCATION DEPARTMENT
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-1892
Mailing Address - Fax:313-993-7118
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:PEDIATRIC EDUCATION DEPARTMENT
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-1892
Practice Address - Fax:313-993-7118
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-1634502080P0204X, 2080P0204X
MI43011103742080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-163450OtherLICENSE