Dr. Husam Mourtada
Sports Medicine Doctor
1330 Boiling Springs Rd Suite 1800
Spartanburg
, South Carolina 29303-4201
Dr. Husam Mourtada
Sports Medicine Doctor
1330 Boiling Springs Rd Suite 1800
Spartanburg
, South Carolina 29303-4201
(864) 560-4413
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Dr. Husam Mourtada
- Po Box 743070
- Atlanta, GA
- Zip : 30374-3070
- Fax : (864) 560-4413
- Phone : (864) 560-4304
Second Address
- Dr. Husam Mourtada
- 1330 Boiling Springs Rd Suite 1800
- Spartanburg, SC
- Zip : 29303-4201
- Phone : (864) 560-9646
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | 26527 | SC |
National Provider Identifier
| NPI | 1114998671 |
|---|---|
| Provider Name | Dr. Husam Mourtada |
| First Address | Atlanta, GA 30374-3070 |
| Second Address | Spartanburg, SC 29303-4201 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/01/2006 |
| Last Update Date | 27/01/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 067EJ | BCBS (01) | NC |
| 265279 | (05) | SC |
| 7806056 | AETNA (01) | SC |
| 89067EJ | (05) | NC |
| D1678 | MEDCOST (01) | SC |
| G52530 | (02) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.