Individual
DR. HUSAM MOURTADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 1800, SPARTANBURG, SC 29303-4201
(864) 560-9646
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
26527
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067EJ
BCBS
NC
05
—
265279
—
SC
01
—
7806056
AETNA
SC
05
—
89067EJ
—
NC
01
—
D1678
MEDCOST
SC
Enumeration date
01/31/2006
Last updated
01/27/2021
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