Provider Demographics
NPI:1831167261
Name:HUSAIN, SYED HAMID (DO)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:HAMID
Last Name:HUSAIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S CATON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5201
Mailing Address - Country:US
Mailing Address - Phone:410-368-3002
Mailing Address - Fax:
Practice Address - Street 1:900 S CATON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5201
Practice Address - Country:US
Practice Address - Phone:410-368-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2424422085R0202X
WI47796-212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1609206OtherINDEPENDENT HEALTH
NY02848777Medicaid
NY000529023003OtherBCBS
WI43520900Medicaid
NY00027956501OtherUNIVERA HEALTHCARE
NYP00408566OtherRR MEDICARE
NY070628000043OtherFIDELIS CARE OF NEW YORK
NY070628000043OtherFIDELIS CARE OF NEW YORK
NY00027956501OtherUNIVERA HEALTHCARE
NYRB4200Medicare PIN
I28741Medicare UPIN