Provider Demographics
NPI:1336169028
Name:HUSSEIN, REZHAN H (MD, FACP, FIDSA)
Entity Type:Individual
Prefix:
First Name:REZHAN
Middle Name:H
Last Name:HUSSEIN
Suffix:
Gender:M
Credentials:MD, FACP, FIDSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8881
Practice Address - Fax:717-531-4633
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246578207RI0200X
PAMD460860207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAA 104639OtherMEDICARE GROUP PTAN
PA1033443940001Medicaid