Individual
MUMTAZ HUSAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15688 ST RT 170, EAST LIVERPOOL, OH 43920
(330) 385-4004
(330) 385-3949
Mailing address
PO BOX 2346, 15688 ST RT 170, EAST LIVERPOOL, OH 43920
(330) 385-4004
(330) 385-3949
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-068803
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0188943
—
OH
Enumeration date
07/14/2006
Last updated
04/25/2012
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