Provider Demographics
NPI:1356385371
Name:HUSSAIN, SHABBAR (MD)
Entity type:Individual
Prefix:
First Name:SHABBAR
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1035 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2986
Mailing Address - Country:US
Mailing Address - Phone:717-264-6211
Mailing Address - Fax:717-264-0406
Practice Address - Street 1:20311 LAPPANS RD STE 100
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-2086
Practice Address - Country:US
Practice Address - Phone:301-432-8470
Practice Address - Fax:301-432-4010
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039475L207X00000X
NMMD2017-0572208VP0000X
MDD0031919208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA718243OtherBLUE SHIELD
PA0000718243OtherAMERIHEALTH
PA0000718243OtherFEDERAL BLUE SHIELD
PA02064901OtherKEYSTONE HEALTH PLAN
PA843612OtherAETNA HMO
PA02064901OtherBLUE CROSS
PA200024821OtherRAILROAD MEDICARE
PAF23031OtherHEALTH AMERICA/ASSURANCE
PA4508105OtherAETNA NON HMO
PA001276846001Medicaid
PA248605OtherMAMSI
PA0555160000OtherPERSONALL CHOICE
MD54940001OtherMARYLAND BLUE CROSS/SHIEL
PA0555160000OtherPERSONALL CHOICE
PA248605OtherMAMSI