Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 46485 | WI |
Y | 2084V0102X | Vascular Neurology | 4301093969 | MI |
NPI | 1023074572 |
---|---|
Provider Name | Syed Hussain |
First Address | East Lansing, MI 48824-7040 |
Second Address | East Lansing, MI 48824-7040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 15/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023074572 | (05) | MI |