1356385371 NPI number — SHABBAR HUSSAIN M.D.

Table of content: SHABBAR HUSSAIN M.D. (NPI 1356385371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356385371 NPI number — SHABBAR HUSSAIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUSSAIN
Provider First Name:
SHABBAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1356385371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1035 WAYNE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-2986
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-264-6211
Provider Business Mailing Address Fax Number:
717-264-0406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20311 LAPPANS RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOONSBORO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21713-2086
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-432-8470
Provider Business Practice Location Address Fax Number:
301-432-4010
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  MD039475L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0000X , with the licence number: MD2017-0572 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0000X , with the licence number: D0031919 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 718243 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000718243 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000718243 . This is a "FEDERAL BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02064901 . This is a "KEYSTONE HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 843612 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02064901 . This is a "BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 200024821 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: F23031 . This is a "HEALTH AMERICA/ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4508105 . This is a "AETNA NON HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001276846001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 248605 . This is a "MAMSI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0555160000 . This is a "PERSONALL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 54940001 . This is a "MARYLAND BLUE CROSS/SHIEL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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