Provider Demographics
NPI:1932168721
Name:RAWJI, HUSSAIN ESMAIL (MD)
Entity Type:Individual
Prefix:
First Name:HUSSAIN
Middle Name:ESMAIL
Last Name:RAWJI
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 1:850 W PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3284
Mailing Address - Country:US
Mailing Address - Phone:386-337-2455
Mailing Address - Fax:
Practice Address - Street 1:850 W PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3284
Practice Address - Country:US
Practice Address - Phone:386-337-3190
Practice Address - Fax:386-337-3189
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65279207Q00000X, 207V00000X
FLME 0065279207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374905300Medicaid
BR4175558OtherDEA
G42753Medicare UPIN
BR4175558OtherDEA
942753Medicare UPIN