Provider Demographics
NPI:1104929587
Name:KHUSRO, HUMA (MD)
Entity type:Individual
Prefix:DR
First Name:HUMA
Middle Name:
Last Name:KHUSRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BAY ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5229
Mailing Address - Country:US
Mailing Address - Phone:256-546-7778
Mailing Address - Fax:256-547-7709
Practice Address - Street 1:106 BAY ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5229
Practice Address - Country:US
Practice Address - Phone:256-547-7778
Practice Address - Fax:256-547-7709
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL194712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529909210Medicaid
AL631281963OtherBLUECROSS/BLUESHIELD
AL529909210Medicaid