Provider Demographics
NPI:1770556102
Name:HUSSAIN, MUZAFFAR (MD)
Entity type:Individual
Prefix:
First Name:MUZAFFAR
Middle Name:
Last Name:HUSSAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:918-540-7782
Mailing Address - Fax:918-540-7784
Practice Address - Street 1:310 2ND AVE SW
Practice Address - Street 2:STE. 207
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6743
Practice Address - Country:US
Practice Address - Phone:918-540-7782
Practice Address - Fax:918-540-7784
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK23306207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200462050EMedicaid
OK200013220AMedicaid
OK318789YKW9Medicare PIN
OK200013220AMedicaid
DB1879Medicare PIN
OK900522214Medicare PIN
249329603Medicare PIN