Provider Demographics
NPI:1649080805
Name:HUSSAIN, IMRAN SYED
Entity type:Individual
Prefix:
First Name:IMRAN
Middle Name:SYED
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8316 LUNSFORD LN
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4416
Mailing Address - Country:US
Mailing Address - Phone:317-677-5215
Mailing Address - Fax:
Practice Address - Street 1:8316 LUNSFORD LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-4416
Practice Address - Country:US
Practice Address - Phone:317-677-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program