Provider Demographics
NPI:1992770739
Name:HUSSEIN, FADHIL A (MD)
Entity type:Individual
Prefix:DR
First Name:FADHIL
Middle Name:A
Last Name:HUSSEIN
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 1:5800 PARK CENTER CT STE A
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-0710
Mailing Address - Country:US
Mailing Address - Phone:419-843-3781
Mailing Address - Fax:419-843-5432
Practice Address - Street 1:5800 PARK CENTER CT STE A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-0710
Practice Address - Country:US
Practice Address - Phone:419-843-3781
Practice Address - Fax:419-843-5432
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301070643207RC0000X
OHOH35065701H207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0995133Medicaid
OH0995133Medicaid
OHHU4033004Medicare ID - Type Unspecified