Provider Demographics
NPI:1992156368
Name:HUSSAINI, SHARMEEN FATIMA (MD)
Entity type:Individual
Prefix:
First Name:SHARMEEN
Middle Name:FATIMA
Last Name:HUSSAINI
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 1:731 12TH AVE NW STE 302
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5765
Mailing Address - Country:US
Mailing Address - Phone:580-220-6200
Mailing Address - Fax:580-220-6258
Practice Address - Street 1:731 12TH AVE NW STE 302
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5765
Practice Address - Country:US
Practice Address - Phone:580-220-6200
Practice Address - Fax:580-220-6258
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK38074208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine