1093764599 NPI number — MEDICAL ARTS OUTPATIENT SERVICES, INC.

Table of content: ASYA YASMINE HUSSAIN MD (NPI 1831769942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093764599 NPI number — MEDICAL ARTS OUTPATIENT SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL ARTS OUTPATIENT SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093764599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2216
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINOT
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58702-2216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-857-5118
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 BURDICK EXPY E
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MINOT
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58701-4768
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-857-7900
Provider Business Practice Location Address Fax Number:
701-857-7834
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KUTCH
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
701-418-8000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 22 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1454946 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3501384 . This is a "NABP" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 20121 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30751 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".




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