Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD023677E | PA |
NPI | 1104988310 |
---|---|
Provider Name | Zahid Husain |
First Address | Wilkes Barre, PA 18702 |
Second Address | Wilkes Barre, PA 18702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0042763000 | INDEPENDENCE BS (01) | PA |
0711610 | (05) | PA |
072067 | FIRST PRIORITY (01) | PA |
B41229 | (02) |