Provider Demographics
NPI:1992796478
Name:HUSAIN, MOHSIN AKBER (MD)
Entity type:Individual
Prefix:
First Name:MOHSIN
Middle Name:AKBER
Last Name:HUSAIN
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 1:8629 SUDLEY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4590
Mailing Address - Country:US
Mailing Address - Phone:703-361-3030
Mailing Address - Fax:703-361-2687
Practice Address - Street 1:8629 SUDLEY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4590
Practice Address - Country:US
Practice Address - Phone:703-361-3030
Practice Address - Fax:703-361-2687
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI117532085R0202X
VA01012395492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10258553Medicaid
9385116OtherPHHCS
AA32150OtherRIHPILGRIM
MA2102820Medicaid
VA10258707Medicaid
VA10258677Medicaid
VA010258596Medicaid
VA10258715Medicaid
RI7057570OtherMEDICAL ASSISTANCE
VA10258553Medicaid