Provider Demographics
NPI:1306537873
Name:HUSSEIN, ABDINAJIB
Entity type:Individual
Prefix:
First Name:ABDINAJIB
Middle Name:
Last Name:HUSSEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3739 S PACKARD AVE APT 218
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:WI
Mailing Address - Zip Code:53235-4325
Mailing Address - Country:US
Mailing Address - Phone:414-331-9360
Mailing Address - Fax:
Practice Address - Street 1:3739 S PACKARD AVE APT 218
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:WI
Practice Address - Zip Code:53235-4325
Practice Address - Country:US
Practice Address - Phone:414-331-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIH2500019600113343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIH2500019600113OtherMEDICAL TRASPORTATION