Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | D88893 | MD |
Y | 111NI0900X | Internist | D88893 | MD |
N | 207R00000X | Internist | MD039045 | DC |
N | 111NI0900X | Internist | MD039045 | DC |
N | 207R00000X | Internist | MD440869 | PA |
N | 111NI0900X | Internist | MD440869 | PA |
N | 207RI0200X | Infectious Disease | 0101250764 | VA |
NPI | 1043539919 |
---|---|
Provider Name | Wesam Hassen Moustafa Hussein |
First Address | Herndon, VA 20171 |
Second Address | Herndon, VA 20171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2010 |
Last Update Date | 23/08/2021 |