Provider Demographics
NPI:1780174284
Name:HUSSAIN, MARIA SYED ABID (MD)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:SYED ABID
Last Name:HUSSAIN
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 1452
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-1223
Mailing Address - Country:US
Mailing Address - Phone:509-547-2204
Mailing Address - Fax:509-542-8836
Practice Address - Street 1:3180 W CLEARWATER AVE STE A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2765
Practice Address - Country:US
Practice Address - Phone:509-547-2204
Practice Address - Fax:509-542-8836
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2021-06-30
Deactivation Date:2019-01-09
Deactivation Code:
Reactivation Date:2019-03-01
Provider Licenses
StateLicense IDTaxonomies
WAMD61147217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine