1578829677 NPI number — RAFIQ A. HUSSAIN M.D F.R.C.P.

Table of content: (NPI 1578829677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578829677 NPI number — RAFIQ A. HUSSAIN M.D F.R.C.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAFIQ A. HUSSAIN M.D F.R.C.P.
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:
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:
1578829677
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 45318
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTLAKE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44145-0318
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-243-7878
Provider Business Mailing Address Fax Number:
440-243-1290

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18660 BAGLEY RD
Provider Second Line Business Practice Location Address:
301 PHASE II
Provider Business Practice Location Address City Name:
MIDDLEBURG HEIGHTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44130-3483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-243-7878
Provider Business Practice Location Address Fax Number:
440-243-1290
Provider Enumeration Date:
04/03/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HUSSAIN
Authorized Official First Name:
RAFIQ
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
440-243-7878

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  354432 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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