Basic Information
Provider Information
NPI: 1689800286
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUSSAIN
FirstName: SAIMA
MiddleName: NAZILY
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherLastNameType:  
Mailing Information
Address1: PO BOX 658
Address2:  
City: GAINESVILLE
State: GA
PostalCode: 305030658
CountryCode: US
TelephoneNumber: 7707181122
FaxNumber: 7705357445
Practice Location
Address1: 725 JESSE JEWELL PKWY SE
Address2:  
City: GAINESVILLE
State: GA
PostalCode: 305013834
CountryCode: US
TelephoneNumber: 7705353611
FaxNumber: 7705357092
Other Information
ProviderEnumerationDate: 06/09/2009
LastUpdateDate: 07/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X68211GAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
2080P0204X68211GAN Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
208000000X068211GAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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