Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 51852 | KY |
N | 207QA0505X | Family Doctor - Adult Medicine | E-7091 | AR |
NPI | 1891960431 |
---|---|
Provider Name | Dr. Raza Hussain |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Crestview Hills, KY 41017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 24/09/2018 |