Individual
SHAHID HUSSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 FREEPORT AVE NW STE 100, ELK RIVER, MN 55330-2723
(763) 581-5200
Mailing address
800 FREEPORT AVE NW STE 100, ELK RIVER, MN 55330-2723
(763) 581-5200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01041443A
IN
207R00000X
Internal Medicine Physician
Primary
73510
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067498
—
IL
05
—
200011080
—
IN
01
—
90001358
BCBSIL
IL
Enumeration date
08/29/2005
Last updated
09/08/2023
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