Provider Demographics
NPI:1295741155
Name:HUSSAIN, MUZAFAR (PT)
Entity type:Individual
Prefix:
First Name:MUZAFAR
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:MUZAFAR
Other - Middle Name:
Other - Last Name:HUSSAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:35 S JOHNSON ST
Mailing Address - Street 2:2G
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-1658
Mailing Address - Country:US
Mailing Address - Phone:248-890-6058
Mailing Address - Fax:586-991-5605
Practice Address - Street 1:35 S JOHNSON ST
Practice Address - Street 2:2G
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1658
Practice Address - Country:US
Practice Address - Phone:248-890-6058
Practice Address - Fax:586-991-5605
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist