Provider Demographics
NPI:1104231992
Name:ABDULHUSEIN, MUSTAFA (MD)
Entity type:Individual
Prefix:DR
First Name:MUSTAFA
Middle Name:
Last Name:ABDULHUSEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1929
Mailing Address - Country:US
Mailing Address - Phone:701-234-3100
Mailing Address - Fax:
Practice Address - Street 1:3300 OAKDALE AVE N # 2E
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-581-8240
Practice Address - Fax:763-581-8241
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRL132232084P0800X
MN649972084P0800X
NDRL 13223282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry