Provider Demographics
NPI:1952535049
Name:KTAICH, NESSRINE HUSSEIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NESSRINE
Middle Name:HUSSEIN
Last Name:KTAICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NESSRINE
Other - Middle Name:HUSSEIN
Other - Last Name:KTAICH-ABOUDAYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:500 OSBORN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1822
Mailing Address - Country:US
Mailing Address - Phone:190-663-5446
Mailing Address - Fax:906-635-4467
Practice Address - Street 1:500 OSBORN BLVD
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1822
Practice Address - Country:US
Practice Address - Phone:190-663-5446
Practice Address - Fax:906-635-4467
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.146364207R00000X
MI4301093679207R00000X, 207RI0200X
WAMD61061932207RI0200X
IN01081351A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine