Provider Demographics
NPI:1770532657
Name:HOSSAIN, KASHFIA D (MD)
Entity type:Individual
Prefix:
First Name:KASHFIA
Middle Name:D
Last Name:HOSSAIN
Suffix:
Gender:F
Credentials:MD
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 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-5404
Mailing Address - Fax:864-226-5647
Practice Address - Street 1:2000 E GREENVILLE ST STE 1500
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1719
Practice Address - Country:US
Practice Address - Phone:864-512-5404
Practice Address - Fax:864-226-5647
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC184172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC184179Medicaid
SCP01094115OtherRR MEDICARE
8132Medicare PIN
SC184179Medicaid
SCP01094115OtherRR MEDICARE